UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549

FORM 10-K

_________________________________________________
(Mark One)
ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the fiscal year ended December 31, 20202022 or
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from                     to                      .
Commission file number 1-5353

TELEFLEX INCORPORATED
(Exact name of registrant as specified in its charter)

Delaware 23-1147939
(State or other jurisdiction of
incorporation or organization)
 (I.R.S. employer identification no.)
   
550 East Swedesford Road, Suite 400, Wayne, Pennsylvania 19087
(Address of principal executive offices) (Zip Code)
Registrant’s telephone number, including area code: (610) 225-6800

Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, par value $1.00 per shareTFXNew York Stock Exchange

Securities registered pursuant to Section 12(g) of the Act:
NONE
_________________________________________________ 
Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act.    Yes  ý     No  ¨
Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act.     Yes  ¨    No  ý
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes  x     No  ¨
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes  x    No  ¨
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and "emerging growth company" in Rule 12b-2 of the Exchange Act.

Large accelerated filer x
 
Accelerated filer ¨
 
Non-accelerated filer ¨
 Smaller reporting company  ☐Emerging growth company ☐
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ¨ ¨
Indicate by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness of its internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act by the registered public accounting firm that prepared or issued its audit report. ☒
If securities are registered pursuant to Section 12(b) of the Act, indicate by check mark whether the financial statements of the registrant included in the filing reflect the correction of an error to previously issued financial statements.

Indicate by check mark whether any of those error corrections are restatements that required a recovery analysis of incentive-based compensation received by any of the registrant's executive officers during the relevant recovery period pursuant to §240.10D-1(b)
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act). Yes    No  x
The aggregate market value of the Common Stock of the registrant held by non-affiliates of the registrant (28,959,834 shares)27,089,952 shares on June 26, 20202022 (the last business day of the registrant’s most recently completed fiscal second quarter) was $10,305,936,126$6,990,562,114(1). The aggregate market value was computed by reference to the closing price of the Common Stock on such date, as reported by the New York Stock Exchange.
The registrant had 46,689,81046,944,155 shares of Common Stock outstanding as of February 23, 202121, 2023.
DOCUMENT INCORPORATED BY REFERENCE:
Certain provisions of the registrant’s definitive proxy statement in connection with its 20212023 Annual Meeting of Stockholders, to be filed within 120 days of the close of the registrant’s fiscal year, are incorporated by reference in Part III hereof.
(1) For purposes of this computation only, the registrant has defined “affiliate” as including executive officers and directors of the registrant and owners of more than five percent of the common stock of the registrant, without conceding that all such persons are “affiliates” for purposes of the federal securities laws.





TELEFLEX INCORPORATED
ANNUAL REPORT ON FORM 10-K
FOR THE YEAR ENDED DECEMBER 31, 20202022
TABLE OF CONTENTS
 Page

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Information Concerning Forward-Looking Statements
All statements made in this Annual Report on Form 10-K, other than statements of historical fact, are forward-looking statements. The words “anticipate,” “believe,” “estimate,” “expect,” “intend,” “may,” “plan,” “will,” “would,” “should,” “guidance,” “potential,” “continue,” “project,” “forecast,” “confident,” “prospects” and similar expressions typically are used to identify forward-looking statements. Forward-looking statements are based on the then-current expectations, beliefs, assumptions, estimates and forecasts about our business and the industry and markets in which we operate. These statements are not guarantees of future performance and are subject to risks and uncertainties, which are difficult to predict. Therefore, actual outcomes and results may differ materially from what is expressed or implied by these forward-looking statements due to a number of factors, including:
changes in business relationships with and purchases by or from major customers or suppliers;
delays or cancellations in shipments;
demand for and market acceptance of new and existing products;
the impact of inflation and disruptions in our inability to provide products toglobal supply chain on us and our customers, which may be due to, among other things, events that impact key distributors,suppliers (particularly sole-source suppliers and vendors that sterilizeproviders of sterilization services), including fluctuations in the cost and availability of resins and other raw materials, as well as certain components, used in the production or sterilization of our products;products, transportation constraints and delays, product shortages, energy shortages or increased energy costs, labor shortages in the United States and elsewhere, and increased operating and labor costs;
our inability to integrate acquired businesses into our operations, realize planned synergies and operate such businesses profitably in accordance with our expectations;
our inability to effectively execute our restructuring programs;
our inability to realize anticipated savings resulting from restructuring plans and programs;
the impact of enacted healthcare reform legislation and proposals to amend, replace or repeal the legislation;
changes in Medicare, Medicaid and third-party coverage and reimbursements;
the impact of tax legislation and related regulations;
competitive market conditions and resulting effects on revenues and pricing;
increases in raw material costs that cannot be recovered in product pricing;
global economic factors, including currency exchange rates, interest rates, trade disputes, sovereign debt issues and international conflicts and hostilities, such as the ongoing conflict between Russia and Ukraine;
public health epidemics including the novel coronavirus (referred to as COVID-19);
difficulties entering new markets; and
general economic conditions.
For a further discussion of the risks relating to our business, see Item 1A, “Risk Factors” in this Annual Report on Form 10-K. We expressly disclaim any obligation to update these forward-looking statements, except as otherwise explicitly stated by us or as required by law or regulation.

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PART I
ITEM 1.    BUSINESS
Teleflex Incorporated is referred to herein as “we,” “us,” “our,” “Teleflex” and the “Company.”
THE COMPANY
Teleflex is a global provider of medical technology products that enhance clinical benefits, improve patient and provider safety and reduce total procedural costs. We primarily design, develop, manufacture and supply single-use medical devices used by hospitals and healthcare providers for common diagnostic and therapeutic procedures in critical care and surgical applications. We market and sell our products to hospitals and healthcare providers worldwide through a combination of our direct sales force and distributors. Because our products are used in numerous markets and for a variety of procedures, we are not dependent upon any one end-market or procedure. We manufacture our products at approximately 35 manufacturing sites, withOur major manufacturing operations are located in the Czech Republic, Germany, Malaysia, Mexico and the United States (the "U.S.").
We are focused on achieving consistent, sustainable and profitable growth and improving our financial performance by increasing our market share and improving our operating efficiencies through:
development of new products and product line extensions;
investment in new technologies and broadening the application of our existing technologies;
expansion of the use of our products in existing markets and introduction of our products into new geographic markets;
achievement of economies of scale as we continue to expand by utilizing our direct sales force and distribution network to sell new products, as well as by increasing efficiencies in our sales and marketing organizations, research and development activities and manufacturing and distribution facilities; and
expansion of our product portfolio through select acquisitions, licensing arrangements and business partnerships that enhance, expand or expedite our development initiatives or our ability to increase our market share.
Our research and development capabilities, commitment to engineering excellence and focus on low-cost manufacturing enable us to bring to market cost effective, innovative products that improve the safety, efficacy and quality of healthcare. Our research and development initiatives focus on developing these products for both existing and new therapeutic applications, as well as developing enhancements to, and product line extensions of, existing products. During 20202022 we introduced several product line extensions and threesix new products. Our portfolio of existing products and products under development consists primarily of Class I and Class II medical devices, most of which require 510(k) clearance by the U.S. Food and Drug Administration ("FDA") for sale in the U.S., and some of which are exempt from the requirement to obtain 510(k) clearance. We believe that seeking 510(k) clearance or qualifying for 510(k)-exempt status reduces our research and development costs and risks, and typically results in a shorter timetable for new product introductions as compared to the premarket approval, or PMA, process that would be required for Class III medical devices. See "Government Regulation" below for additional information.
HISTORY AND RECENT DEVELOPMENTS
Teleflex was founded in 1943 as a manufacturer of precision mechanical push/pull controls for military aircraft. From this original single market, single product orientation, we expanded and evolved through entries into new businesses, development of new products, introduction of products into new geographic or end-markets and acquisitions and dispositions of businesses. Throughout our history, we have continually focused on providing innovative, technology-driven, specialty-engineered products that help our customers meet their business requirements.
Beginning in 2007, we significantly changed the composition of our portfolio of businesses, expanding our presence in the medical device industry, while divesting all of our other businesses, which served the aerospace, automotive, industrial and marine markets. Following the divestitures of our marine business and cargo container and systems businesses in 2011, we became exclusively a medical device company.
In 2017, we completed two large scale acquisitions: NeoTract, Inc. ("NeoTract") and Vascular Solutions, Inc. (“Vascular Solutions”). NeoTract was a medical device company that developed and commercialized the UroLift System, a minimally invasive medical device for treating lower urinary tract symptoms due to benign prostatic hyperplasia, or BPH. Vascular Solutions was a medical device company that developed and marketed clinical products for use in minimally invasive coronary and peripheral vascular procedures.
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In 2021, we divested certain product lines within our global respiratory product portfolio to Medline Industries, Inc. (“Medline”) (the "Respiratory business divestiture"). We completed the initial phase of the Respiratory business divestiture on June 28, 2021. The second and final phase of the Respiratory business divestiture will occur once we transfer certain additional manufacturing assets to Medline and is expected to occur prior to the end of 2023.
See "Our Products" below and Note 4 to the consolidated financial statements included in this Annual Report on Form 10-K for additional information.
We expect to continue to increase the size of our business through a combination of acquisitions and organic growth initiatives. In addition, we may identify further opportunities to expand our margins through strategic divestitures of existing businesses and product lines that no longer meet our objectives.

Restructuring programs

We continue to execute our footprint realignment and other restructuring programs designed to improve efficiencies in our manufacturing and distribution facilities and, to a lesser extent, our sales and marketing and research and development organizations. See Note 5 to the consolidated financial statements included in this Annual Report on Form 10-K for additional information.
OUR SEGMENTS
We have four segments: Americas, EMEA (Europe, the Middle East and Africa), Asia (Asia Pacific) and OEM (Original Equipment Manufacturer and Development Services).
Each of our three geographic segments provides a comprehensive portfolio of medical technology products used by hospitals and healthcare providers. However, certain of our products are more heavily concentrated within certain segments. For example, most of our urology products are sold by our EMEA segment and most of our interventional urology products are sold by our Americas segment. Our product portfolio is described in the products section below.
Our OEM segment designs, manufactures and supplies devices and instruments for other medical device manufacturers. Our OEM division, which includes the TFX Medical OEM, TFX OEM, Deknatel and HPC Medical brands, provides custom extrusions, micro-diameter film-cast tubing, diagnostic and interventional catheters, balloons and balloon catheters, film-insulated fine wire, coated mandrel wire, conductors, sheath/dilator introducers, specialized sutures and performance fibers, bioabsorbable sutures, yarns and resins.
The following charts depict our net revenues by reportable operating segment as a percentage of our total consolidated net revenues for the years ended December 31, 2020, 20192022, 2021 and 2018.2020:
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OUR PRODUCTS
Our product categories within our geographic segments include vascular access, anesthesia, interventional, surgical, interventional urology, respiratory and urology. Each of these categories and the key products sold therein are described in more detail below.
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Vascular Access: Our Vascular Access product category offers devices that facilitate a variety of critical care therapies and other applications with a focus on helping reduce vascular-related complications. These products primarily consist of our Arrow branded catheters, catheter navigation and tip positioning systems and our intraosseous, or in the bone, access systems.
Our catheters are used in a wide range of procedures, including the administration of intravenous therapies, the measurement of blood pressure and the withdrawal of blood samples through a single puncture site. Many of our catheters provide antimicrobial and antithrombogenic protection technology that have been shown to reduce the risk of catheter related bloodstream infections and microbial colonization and thrombus accumulation on catheter surfaces.
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Our intraosseous access systems are designed for the delivery of medications and fluids when intravenous access is difficult to obtain in emergent, urgent or medically necessary cases. Our products offer a method for vascular access that can be administered quickly and effectively in the hospital and pre-hospital environments and include the EZ-IO Intraosseous Vascular Access System and Arrow FAST1 Sternal Intraosseous Infusion System.
Interventional: Our Interventional product category offers devices that facilitate a variety of applications to diagnose and deliver treatment via the vascular system of the body. These products primarily consist of a variety of coronary catheters, structural heart therapies,support devices, peripheral intervention products and cardiac assist products that aremechanical circulatory support platform used by interventional cardiologists, interventional radiologists and vascular surgeons. Clinical benefits of our products include increased vein and artery access, post-procedure closure, and increased support during complex medical procedures. Our primary product offerings consistsconsist of a portfolio of Arrow branded intra-aortic balloon pumps and catheters, GuidelineGuideLiner, Turnpike and TraplinerTrapLiner catheters, the MantaMANTA Vascular Closure device and Arrow OnControl devices.powered bone biopsy system.
Anesthesia: Our Anesthesia product category is comprised of airway, and pain management and hemostatic product lines that support hospital, emergency medicine and military channels.
Our airway management products and related devices are designed to enable use of standard and advanced anesthesia techniques in both pre-hospital emergency and hospital settings. Our key products include laryngoscopes, supraglottic airways, endotracheal tubes and atomization devices, which are branded under our LMA, Rusch and MAD tradenames.trade names.
Our pain management product line includes epidurals, catheters and disposable pain pumps for regional anesthesia, designed to improve patients’ post-operative pain experience, which are branded under our Arrow tradename.trade name.
Our hemostatic products accelerate the body's natural clotting cascade and are used in trauma situations where bleeding is difficult to control. The portfolio consists of external hemostats used by first responders, interventional products used in the catheter lab, and trauma products used by trauma surgeons, which are branded under our QuikClot trade name.
Surgical:Our Surgical product category consists of single-use and reusable products designed to provide surgeons with devices for use in a variety of surgical procedures. These products primarily consist of metal and polymer ligation clips, fascial closure surgical systems used in laparoscopic surgical procedures, percutaneous surgical systems and other surgical instruments. Our significant surgical brands include Weck, Minilap,MiniLap, Pleur-Evac, Deknatel, KMedic and Pilling. In 2022, we expanded our product portfolio with the acquisition of Standard Bariatrics, Inc. (“Standard Bariatrics”) and the Titan SGS brand, a powered stapling technology for bariatric surgery.

Interventional Urology: Our interventional urology product category includes the UroLift System, a minimally invasive technology for treating lower urinary tract symptoms due to benign prostatic hyperplasia, or BPH. The UroLift System involves the placement of permanent implants, typically through a transurethral outpatient procedure, that hold the prostate lobes apart to relieve compression on the urethra without cutting, heating or removing prostate tissue. Our Interventional Urology product portfolio is most heavily weighted in our Americas segment.
Respiratory: Our respiratory products are used in a variety of care settings and includeprimarily consist of humidification and oxygen therapy products. The Respiratory business divestiture included products marketed under the Hudson RCI brand name that comprised oxygen therapy products, aerosol therapy products, spirometry products and ventilation management products marketed under the Hudson RCI brand name.products.
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Urology: Our urology product portfolio provides bladder management for patients in the hospital and individuals in the home care markets. The product portfolio consists principally of a wide range of catheters (including Foley intermittent, external and suprapubic)intermittent), urine collectors, catheterization accessories and products for operative endourology, which are marketed under the Teleflex and Rusch brand name.names. Our urology product portfolio is most heavily weighted in our EMEA segment.
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OUR MARKETS
We generally serve three end-markets: hospitals and healthcare providers, medical device manufacturers and home care. These markets are affected by a number of factors, including demographics, utilization and reimbursement patterns. The following charts depict the percentage of net revenues for the years ended December 31, 2020, 20192022, 2021 and 20182020 derived from each of our end markets.markets:
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GOVERNMENT REGULATION
We are subject to comprehensive government regulation both within and outside the U.S. relating to the development, manufacture, sale and distribution of our products.
Regulation of Medical Devices in the U.SU.S.
All of our medical devices manufactured or distributed in the U.S. are subject to requirements set forth by the Federal Food, Drug, and Cosmetic Act (“FDC Act”) and regulations promulgated by the FDA under the FDC Act, which are enforced by the FDA. The FDA and, in some cases, other government agencies administer requirements for the methods used in, and the facilities and controls used for, the design, manufacture, packaging, labeling, storage, installation, servicing, marketing, importing and exporting of all finished devices intended for human use. Additional FDA requirements include premarket clearance and approval, advertising and promotion, distribution and post-market surveillance of our medical devices and establishment of registration and device listing for our facilities.

Unless an exemption, pre-amendment grandfather status (that is, medical devices legally marketed in the U.S. before May 28, 1976) or FDA enforcement discretion applies, each medical device that we market in the U.S. must first receive either clearance as a Class I or, typically, a Class II device (after submitting a premarket notification (“510(k)”) or approval as a Class III device (after filing a premarket approval application (“PMA”)) from the FDA pursuant to the FDC Act. To obtain 510(k) clearance, a manufacturer must demonstrate to the FDA that the proposed device is substantially equivalent to a legally marketed device (a 510(k)-cleared device, a pre-amendment device for which FDA has not called for PMAs or a device with a de novo authorization), referred to as the "predicate device." Substantial equivalence is established by the applicant showing that the proposed device has the same intended use as the predicate device, and it either has the same technological characteristics or has been shown to be equally safe and effective and does not raise different questions of safety and effectiveness as compared to the predicate device. The FDA’s 510(k) clearance process requires regulatory competence to execute and usually takes four to nine months, but it can last longer. A device that is not eligible for the 510(k) process because there is no predicate device may be reviewed by the FDA through the de novo process (the process for granting marketing authorization when no substantially equivalent device exists) if the FDA agrees it is a low to moderate risk device. A device that is not exempt from premarket review and is not eligible for 510(k) clearance or de novo authorization is categorized as Class III and must follow the PMA approval pathway, which requires proof of
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the safety and effectiveness of the device to the FDA’s satisfaction. The process of obtaining PMA approval also requires specific regulatory competence and is more costly, lengthy and uncertain than the 510(k) or de novo processes. The PMA process generally takes from one to three years or even longer. Our portfolio of existing products and pipeline of potential new products consist primarily of Class I (510(k) exempt) and Class II devices that require 510(k) clearance, although a few are 510(k)-
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exempt.-exempt. In addition, certain modifications made to devices after they receive clearance or approval may require a new 510(k) clearance or approval of a PMA or PMA supplement. We cannot be sure that 510(k) clearance or PMA approval will be obtained in a timely matter if at all for any device that we propose to market.
A clinical trial is almost always required to support a PMA application and is sometimes required for a 510(k) clearance or a de novo authorization. The sponsor of a clinical trial must comply with and conduct the study in accordance with the applicable federal regulations, including FDA’s requirements for investigational device exemptions (“IDE”) requirements and good clinical practice (“GCP”). Clinical trials must also be approved, and are subject to continuing oversight, by an institutional review board ("IRB"), which is an appropriately constituted group that has been formally designated to review biomedical research involving human subjects and which has the authority to approve, require modifications to, or disapprove research to protect the rights, safety, and welfare of human research subjects. The FDA may order the temporary or permanent hold or discontinuation of a clinical trial at any time, or impose other sanctions, if it believes that the clinical trial either is not being conducted in accordance with FDA requirements or presents an unacceptable risk to the clinical trial subjects. An IRB may also require the clinical trial to be halted at a given clinical trial site for failure to comply with the IRB’s requirements or to adequately ensure the protection of human subjects, or may impose other conditions. Conducting medical device clinical trials is a complex and costly activity and frequently requires the use of outsourced resources that specialize in planning, conducting and/or monitoring the clinical trial for the medical device manufacturer.
A device placed on the market must comply with numerous regulatory requirements. Those regulatory requirements include, but are not limited to, the following:
device listing and establishment registration;
adherence to the Quality System Regulation (“QSR”), which requires stringent design, testing, control, documentation, complaint handling and other quality assurance procedures;
labeling, including advertising and promotion, requirements;
prohibitions against the promotion of off-label uses or indications;
adverse event and malfunction reporting (Medical Device Reports or "MDRs");
post-approval restrictions or conditions, potentially including post-approval clinical trials or other required testing;
post-market surveillance requirements;
the FDA’s recall authority, whereby it can require or request the recall of products from the market; and
reporting and documentation of voluntary corrections or removals.
The FDA has issued final regulations regarding the Unique Device Identification (“UDI”) System, which requires manufacturers to label or mark certain medical devices and/or their packaging with unique identifiers. Although the FDA expects that the UDI System will help track products during recalls and improve patient safety, it has required us to make changes to our manufacturing and labeling, which could increase our costs.labeling. The UDI System is beingwas implemented in stages based on device risk, with the first requirements having taken effect in September 2014 and the last taking effect in SeptemberDecember 2022.
Certain of our medical devices are sold in kits that include a drug component, such as lidocaine. These types of kits are generally regulated as combination products within the Center for Devices and Radiological Health ("CDRH") under the device regulations because the device provides the primary mode of action of the kit. Although the kit as a whole is regulated as a medical device, it may be subject to certain drug requirements such as current good manufacturing practices (“cGMPs”) and adverse drug experience reporting requirements, to the extent applicable to the drug-component repackaging activities and subject to inspection to verify compliance with cGMPs as well as other regulatory requirements.
Our manufacturing facilities, as well as those of certain of our suppliers, are subject to periodic and for-cause inspections by FDA personnel to verify compliance with the QSR (21 CFR Part 820) as well as other regulatory requirements. Similar inspections and audits are performed by Notified Bodies to verify compliance to applicable
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ISO standards (e.g. ISO 13485:2016), by auditing organizations under the Medical Device Single Audit Program ("MDSAP") applicable to regulatory requirements of Australia, Brazil, Canada, Japan and the U.S., and/or by regulatory authorities to verify compliance with medical device regulations and requirements from the countries in which we distribute product. If the FDA were to find that we or certain of our suppliers have failed to comply with
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applicable regulations, it could institute a wide variety of enforcement actions, ranging from issuance of a warning or untitled letter to more severe sanctions, such as product recalls or seizures, civil penalties, consent decrees, injunctions, criminal prosecution, operating restrictions, partial suspension or total shutdown of production, refusal to permit importation or exportation, refusal to grant, or delays in granting, clearances or approvals or withdrawal or suspension of existing clearances or approvals. The FDA also has the authority under certain circumstances to request repair, replacement or refund of the cost of any medical device manufactured or distributed by us. Any of these actions could have an adverse effect on our business.
Regulation of Medical Devices Outside of the U.S.
Medical device laws also are in effect in many of the markets outside of the U.S. in which we do business. These laws range from comprehensive device approval requirements for some or all of our products to requests for product data or certifications. Inspection of and controls over manufacturing, as well as monitoring of device-related adverse events, are components of most of these regulatory systems. Manufacturing certification requirements and audits through the MDSAP program or other regulatory authority inspections also apply. In addition, the European Union (“EU”) has adopted the EU Medical Device Regulation (the “EU MDR”), which imposes stricter requirements for the marketing and sale of medical devices (as compared to the predecessor Medical Device Directive)Directive (the "EU MDD")), including in the area of clinical evaluation requirements, quality systems, economic operators and post-market surveillance. ManufacturersThe EU MDR went into effect in May 2021. As of the effective date, new and modified devices must be certified under, and be compliant with, the EU MDR. Devices that previously satisfied EU MDD requirements can continue to be marketed in the EU, subject to certain limitations, until the expiration of their current EU MDD certifications, which may be no later than May 2024, but certain EU MDR requirements went into effect for such devices in May 2021. In February 2023, the European Parliament and Council approved an amendment to extend the EU MDR certification deadline for currently marketed medical devices will havepast May 2024, with December 2027 as the new deadline for highest-risk devices and December 2028 for lower-risk devices. Failure to obtain EU MDR certifications prior to the expiration of existing EU MDD certifications may limit our ability to sell certain products in the EU until May 2021EU MDR certification is obtained. Failure to meet the requirements of theapplicable EU MDR. Failure to meet theseMDR requirements could adversely impact our business in the EU and other regions that tie their product registrations to the EU requirements.
Healthcare Laws
We are subject to various federal, state and local laws in the U.S. targeting fraud and abuse in the healthcare industry. These laws prohibit us from, among other things, soliciting, offering, receiving or paying any remuneration to induce the referral or use of any item or service reimbursable under Medicare, Medicaid or other federally or state financed healthcare programs. Violations of these laws are punishable by imprisonment, criminal fines, civil monetary penalties and exclusion from participation in federal healthcare programs. In addition, we are subject to federal and state false claims laws in the U.S. that prohibit the submission of false payment claims under Medicare, Medicaid or other federally or state funded programs. Certain marketing practices, such as off-label promotion, and violations of federal anti-kickback laws may also constitute violations of these laws.
In addition, we are subject to various federal and state reporting and disclosure requirements related to the healthcare industry. Rules issued by the Centers for Medicare & Medicaid Services ("CMS") require us to collect and report information on payments or transfers of value to physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, certified nurse-midwives and teaching hospitals, as well as investment interests held by physicians and their immediate family members. Effective January 2022, we will also be required to collect and report information on payments or transfers of value to physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and certified nurse-midwives. The reported data is available to the public on the CMS website. Failure to submit required information may result in civil monetary penalties. In addition, several states now require medical device companies to report expenses relating to the marketing and promotion of device products and to report gifts and payments to individual physicians in these states. Other states prohibit various other marketing-related activities. The federal government and certain other states require the posting of information relating to clinical studies and their outcomes. The shifting commercial compliance environment and the need to build and maintain robust and expandable systems to comply with the different compliance and/or reporting requirements among a number of jurisdictions increases the possibility that a healthcare company may violate one or more of the requirements, resulting in increased compliance costs that could adversely impact our results of operations.
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Further, the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act (collectively, the “Affordable Care Act”), imposed regulatory mandates and other measures designed to contain the cost of healthcare, in addition to annual reporting and disclosure requirements on device manufacturers for any “transfer of value” made or distributed to physicians or teaching hospitals. Violations of these laws are punishable by a range of fines, penalties and other sanctions.
Other Regulatory Requirements
We are also subject to the U.S. Foreign Corrupt Practices Act and similar anti-bribery laws applicable in jurisdictions outside the U.S. that generally prohibit companies and their intermediaries from improperly offering or paying anything of value to non-U.S. government officials for the purpose of obtaining or retaining business. Because of the predominance of government-sponsored healthcare systems around the world, most of our
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customer relationships outside of the U.S. are with government entities and are therefore subject to such anti-bribery laws. Our policies mandate compliance with these anti-bribery laws. We operate in many parts of the world that have experienced government corruption to some degree, and in certain circumstances, strict compliance with anti-bribery laws may conflict with local customs and practices. In the sale, delivery and servicing of our medical devices and software outside of the U.S., we must also comply with various export control and trade embargo laws and regulations, including those administered by the Department of Treasury’s Office of Foreign Assets Control (“OFAC”) and the Department of Commerce’s Bureau of Industry and Security (“BIS”) which may require licenses or other authorizations for transactions relating to certain countries and/or with certain individuals identified by the U.S. government. Despite our global trade and compliance program, our internal control policies and procedures may not always protect us from reckless or criminal acts committed by our employees, distributors or other agents. Violations of these requirements are punishable by criminal or civil sanctions, including substantial fines and imprisonment.
COMPETITION
The medical device industry is highly competitive. We compete with many companies, ranging from small start-up enterprises to companies that are larger and more established than us and have access to significantly greater financial resources. Furthermore, extensive product research and development and rapid technological advances characterize the market in which we compete. We must continue to develop and acquire new products and technologies for our businesses to remain competitive. We believe that we compete primarily on the basis of clinical superiority and innovative features that enhance patient benefit, product reliability, performance, customer and sales support, and cost-effectiveness.
SALES AND MARKETING
Our product sales are made directly to hospitals, healthcare providers, distributors and to original equipment manufacturers of medical devices through our own sales forces, independent representatives and independent distributor networks.
BACKLOG
Most of our products are sold to hospitals or healthcare providers on orders calling for delivery within a few days or weeks, with longer order times for products sold to medical device manufacturers. Therefore, our backlog of orders is not indicative of revenues to be anticipated in any future 12-month period.
PATENTS AND TRADEMARKS
We own a portfolio of patents, patents pending and trademarks. We also license various patents and trademarks. Patents for individual products extend for varying periods based upon the date of patent filing or grant and the legal term of patents in the various countries where patent protection is obtained. Trademark rights may potentially extend for longer periods of time and are dependent upon national laws and use of the marks. All product names throughout this document are trademarks owned by, or licensed to, us or our subsidiaries. Although these have been of value and are expected to continue to be of value in the future, we do not consider any single patent or trademark, except for the Teleflex name and the Arrow and UroLift brands, to be essential to the operation of our business.
SUPPLIERS AND MATERIALS
Materials used in the manufacture and sterilization of our products are purchased from a large number of suppliers in diverse geographic locations. We are not dependent on any single supplier for a substantial amount of the materials used, the components supplied and the sterilization services provided for our overall operations. Most
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of the materials, components and sterilization services we utilize are available from multiple sources, and where practical, we attempt to identify alternative suppliers. However, our ability to establish alternate sources of supply of materials and sterilization services may be delayed due to FDA and other regulatory authority requirements regarding the manufacture and sterilization of our products. Volatility in commodity prices, particularly with respect to aluminum, steel and plastic resins,freight costs, can have a significant impact on the cost of producing and supplying certain of our products. We may not be able to successfully pass cost increases through to all of our customers, particularly original equipment manufacturers.
RESEARCH AND DEVELOPMENT
We are engaged in both internal and external research and development. Our research and development efforts support our strategic objectives to provide innovative new, safe and effective products that enhance clinical value by
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reducing infections, improving patient and clinician safety, enhancing patient outcomes and enabling less invasive procedures.
We also acquire or license products and technologies that are consistent with our strategic objectives and enhance our ability to provide a full range of product and service options to our customers.
SEASONALITY
Portions of our revenues are subject to seasonal fluctuations. Incidence of flu and other disease patterns and, to a lesser extent, the frequency of elective medical procedures affect revenues related to single-use products. Historically, we have experienced higher sales in the fourth quarter as a result of these factors.
HUMAN CAPITAL RESOURCES
As of December 31, 2020,2022, we employed approximately 14,00015,500 employees, including 4,000 employees in the U.S. and 10,00011,500 employees in 3132 other countries around the world. Our manufacturingglobal supply chain employees make up 58% of the total employee population and are located primarily in Mexico, Malaysia and the Czech Republic. Our commercial organization comprises 25%24% of the global employee base, located throughout the globe.base. The remaining 17%18% of employees work in various corporate functions, based in each of our locations.
We believe our employees are a significant differentiating factor and play a critical role in our ability to deliver on our commitments to patients and execute our strategy to our customers and shareholders. Our management team places significant focus and attention to matters affecting our people, particularly our commitment to our Core Values, capability development, total rewards and diversity, as well as how each employee experiences our culture.
Culture
The culture of our organization is critical to the human capital we attract, develop and retain and who, in turn, contribute to the results and success of our organization. Our culture is framed by our Core Values – building trust, entrepreneurial spirit and making our workplace fun, with people at the center of all we do. We strive to develop and sustain our culture by embedding these values in all aspects of our organization, including our human capital strategies.
Diversity, Equity, and Inclusion
At Teleflex, our Core Values define our company, shape our culture, guide our business practices, and direct the way we interact with our stakeholders. Rooted in our Core Values, diversity, equity, and inclusion (DEI) plays an essential role in fulfilling our company core purpose to improve the health and quality of peoples’ lives. Through embedding the principles of DEI into our activities, decisions, governance, innovations, and culture, we contribute to the achievement of accessible, equitable and sustainable healthcare for all.

DEI initiatives in Teleflex are supported by our Global DEI Council, composed of senior leadership from across the organization, and our four Regional DEI Councils in each the US & Canada, LATAM, EMEA, and APAC. The Regional DEI Councils are representative of employees from all levels, functions, and regions, acting as a guiding hub of perspectives and experiences to enrich the importance of DEI in Teleflex.

Within our Regional DEI Councils, each of our Employee Resources Groups (ERGs) are represented by a member of their leadership committee to share the progress, knowledge, and initiatives from their respective ERG. Our ERG footprint extends to each of our four regions, providing our people with employee-driven communities that focus on initiatives such as supporting working parents & caregivers, coordinating mentorship and development opportunities, promoting cultural awareness and understanding, and connecting employees with shared experiences, interests or backgrounds.

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We continue our efforts to cultivate a diverse workforce that reflects the communities in which we work and serve. These efforts are supported through engaging and partnering with local organizations, educational institutions and recruiting firms for a variety of opportunities in Teleflex including vacancies, co-op placements and internships. In partnering with local organizations, we are better able to address how we can best serve and support marginalized populations in our communities.

We collect and regularly review several measures of the diversity within our global workforce. Some illustrative and notable highlights of our new hires from the January to December 2022 period are as follows:
At 58%, females made up the majority of our new hires globally;
Of the 5,654 total global hires, 51% were aged 20-29, followed by 24% aged 30-39 and 12% aged 40-49; and
In the US, approximately 50% of our new hires represented minority ethnicities including Black (23%), Asian (13%), and Hispanic (10%)
Talent Management, Development and Learning
We are committed to providing our employees with opportunities for growth, development, and career advancement and to building a high-performance culture that supports our Core Values throughout the employee lifecycle. We have implemented a talent management process that provides regular coaching check-ins between employees and their managermanagers to review the employee’s developmental objectives and career progression. We also regularly review our talent portfolio and succession plans to ensure we can deliver on our company strategy.
In addition, we offer a number of internal educational and training resources to employees throughout our organization. Among these resources is the Teleflex Academy, a curriculum that provides learning opportunities for our employees to further develop their skills and receive training across broad subject areas such as leadership; communications; diversity, equity, and inclusion; sales; customer service; and business acumen.
Diversity, Equity and Inclusion
We believe that diversity, equity, and inclusion (DEI) drives value for employees, patients, customers and shareholders by engaging a broad range of perspectives and experiences to enrich our offering to these communities. We are continuing to cultivate this diversity through the efforts of our Corporate DEI Council and four regional DEI councils (North America, Latin America, EMEA and APAC), whose goals include supporting the attraction, development and retention of diverse employees in alignment with our Core Values.
One pillar of our DEI platform includes sponsoring our globally expanding Employee Resource Groups (ERGs) which we initiated with Women Inspiring Learning and Leadership in 2016, and which have since grown to include several other ERGs as of the end of 2020. Our ERGs are managed by employees and participation is open to all.
In our efforts to provide a diverse slate of candidates to our hiring managers, we deploy several recruitment channels to source talent from a variety of organizations including multiple social media outlets, co-op placement, local universities and technology institutes. We also work with numerous external recruiting firms that focus on diverse candidates.
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Total Rewards
WeOur commitment to our employees is to provide fair, equitable and competitive compensation and benefits packages to all employees globally, regardless of gender, age or ethnicity. To that end we continuously review and calibrate employee roles and responsibilities to ensure we are offering equal pay for equal work, and we actively manage our global compensation and benefit programs to ensure we can attract and retain the critical human capital we need to continue to deliver on our commitments to employees, customers, patients and shareholders. We believe our compensation and benefits offering is aligned to competitive market pay levels and, along with our culture and Core Values, acts to incentivize the right behaviors and actions to achieve the best results for the organization. We structure our compensation to include a mix of pay components of base salary, short-term cash incentives and long-term incentives. We offer our employees health, welfare and retirement benefits and have implemented policies addressing paid time off, flexible work schedules, employee assistance, parental leave and family benefits, among others.
In 2021, we performed an in-depth pay equity analysis on the pay practices within our organization. As part of that analysis on our compensation programs, no systemic gender bias was identified globally and within the United States, no systemic ethnicity bias was identified. We continue to explore where we can expand our pay equity analyses for every jurisdiction in which we operate. We are committed to conducting pay equity analyses on a regular, periodic basis to ensure we continue to align to our commitments and Core Values.
Environmental, Health and Safety
Our Environmental Health and Safety (EHS) vision is to protect the safety and health of Teleflex personnel and the environments in which we operate. We have a vested interest in protecting our most valuable assets – our employees. Everyone is a steward of EHS, fostering a culture of being actively responsible in all our operations. We remain fully committed to complying with all relevant EHS legislation and to achieving our vision. We have and will continue to expend resources to construct, maintain, operate, and improve our facilities across the globe for environmental, health, safety and sustainability of our operations. For example, in response to the risks associated with the COVID-19 pandemic, we have expended resources to implement various safety measures, including implementing social distancing protocols and expanding personal protective equipment availability and usage, across our facilities globally in an effort to protect the health and safety of our employees and others. Further, we understand that our environment is both complex and delicate, and we prioritize managing and limiting the impact our business has on the environment as part of our Zero Harm Culture. As we continue to review our commitments to environmental sustainability, we have initiated programs to track and lower our consumption of energy, water and gas as well as reduce waste and the use of hazardous materials. In addition, we have developed an EHS program
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focused in the areas of training our personnel with respect to, deploying and auditing global EHS standards as well as other programs to engage our employees on EHS initiatives.
ENVIRONMENTAL
We are subject to various environmental laws and regulations both within and outside the U.S. Our operations, like those of other medical device companies, involve the use of substances regulated under environmental laws, primarily in manufacturing and sterilization processes. While we continue to devote resources to compliance with existing environmental laws and regulations, we cannot ensure that our costs of complying with current or future environmental protection, health and safety laws and regulations, including, without limitation, those related to climate change, will not exceed our estimates or will not have a material adverse effect on our business, financial condition, results of operations and cash flows. Further, we cannot ensure that we will not be subject to environmental claims for personal injury or cleanup in the future based on our past, present or future business activities.
INVESTOR INFORMATION
We are subject to the reporting requirements of the Securities Exchange Act of 1934, as amended (the “Exchange Act”). Therefore, we file reports, proxy statements and other information with the Securities and Exchange Commission (SEC). The SEC maintains a website (http://www.sec.gov) that contains reports, proxy and information statements and other information regarding issuers that file electronically with the SEC.
You can access financial and other information about us in the Investors section of our website, which can be accessed at www.teleflex.com. We make available through our website, free of charge, copies of our annual report on Form 10-K, quarterly reports on Form 10-Q, current reports on Form 8-K and amendments to those reports filed with or furnished to the SEC under Section 13(a) or 15(d) of the Exchange Act as soon as reasonably practicable after electronically filing or furnishing such material to the SEC. The information on our website is not part of this Annual Report on Form 10-K. The reference to our website address is intended to be an inactive textual reference only.
We are a Delaware corporation incorporated in 1943. Our executive offices are located at 550 East Swedesford Road, Suite 400, Wayne, PA 19087.
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INFORMATION ABOUT OUR EXECUTIVE OFFICERS
The names and ages of our executive officers and the positions and offices held by each such officer are as follows:
NameAgePositions and Offices with Company
Liam J. Kelly5456Chairman, President and Chief Executive Officer
Thomas E. Powell5961Executive Vice President and Chief Financial Officer
Cameron P. Hicks5658Corporate Vice President, Human Resources and Communications
Daniel V. Logue4749Corporate Vice President, General Counsel and Secretary
Jay White4749Corporate Vice President and President, Global Commercial
Mario Wijker53Corporate Vice President, QA/RA
James Winters4850Corporate Vice President, Manufacturing and Supply Chain
Mr. Kelly has been our President and Chief Executive Officer since January 2018 and has been Chairman of our Board of Directors since May 2020. From May 2016 to December 31, 2017, Mr. Kelly served as our President and Chief Operating Officer. From April 2015 to April 2016, he served as Executive Vice President and Chief Operating Officer. From April 2014 to April 2015, Mr. Kelly served as Executive Vice President and President, Americas. From June 2012 to April 2014 Mr. Kelly served as Executive Vice President and President, International. He also has held several positions with regard to our EMEA segment, including President from June 2011 to June 2012, Executive Vice President from November 2009 to June 2011, and Vice President of Marketing from April 2009 to November 2009. Prior to joining Teleflex, Mr. Kelly held various senior level positions with Hill-Rom Holdings, Inc., a medical device company, from October 2002 to April 2009, serving as its Vice President of International Marketing and R&D from August 2006 to February 2009.
Mr. Powell has been our Executive Vice President and Chief Financial Officer since February 2013. From March 2012 to February 2013, Mr. Powell was Senior Vice President and Chief Financial Officer. He joined Teleflex in August 2011 as Senior Vice President, Global Finance. Prior to joining Teleflex, Mr. Powell served as Chief Financial Officer and Treasurer of Tomotherapy Incorporated, a medical device company, from June 2009 until
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June 2011. In 2008, he served as Chief Financial Officer of Textura Corporation, a software provider. From April 2001 until January 2008, Mr. Powell was employed by Midway Games, Inc., a software provider, serving as its Executive Vice President, Chief Financial Officer and Treasurer from September 2001 until January 2008. Mr. Powell has also held leadership positions with Dade Behring, Inc., PepsiCo, Bain & Company, Tenneco Inc. and Arthur Andersen & Company.
Mr. Hicks has been our Corporate Vice President, Human Resources and Communications since April 2013. Prior to joining Teleflex, Mr. Hicks served as Executive Vice President of Human Resources & Organizational Effectiveness for Harlan Laboratories, Inc., a private global provider of pre-clinical and non-clinical research services, from July 2010 to March 2013. From April 1990 to January 2010, Mr. Hicks held various leadership roles with MDS Inc., a provider of products and services for the development of drugs and the diagnosis and treatment of disease, including Senior Vice President of Human Resources for MDS’ global Pharma Services division from November 2000 to January 2010.
Mr. Logue has been our Corporate Vice President, General Counsel and Secretary since January 2021. Mr. Logue joined Teleflex in 2004 and previously held the positions of Deputy General Counsel from February 2017 to December 2020, Associate General Counsel from March 2013 to January 2017 and Assistant General Counsel from June 2004 to February 2013. Prior to joining Teleflex, Mr. Logue was an associate at the law firm of Pepper Hamilton LLP (now Troutman Pepper Hamilton Sanders LLP) from September 1999 to June 2004.
Mr. White has been our Corporate Vice President and President, Global Commercial since February 2021. From February 2017 to January 2021, Mr. White served as our President, The Americas, and from December 2013 to January 2017 he served as President and General Manager, Vascular. From January 2013 to November 2013, Mr. White served as our President and General Manager, Surgical. Prior to that, he served as our Vice President and General Manager, Surgical from January 2010 to December 2012. Mr. White joined Teleflex in March 2005 as our Director of Marketing, North America. Prior to joining Teleflex, Mr. White worked at Covidien plc (now part of Medtronic plc) where he held senior leadership positions in sales and marketing over a five-year period.
Mr. Wijker has been our Corporate Vice President, Quality Assurance and Regulatory Affairs since January 2019. Prior to joining Teleflex, Mr. Wijker served as Global Vice President Quality and Regulatory for Mölnlycke Health Care AB, a medical device company, from May 2016 to December 2018. From April 2014 to January 2016,
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Mr. Wijker served as Senior Director Global Regulatory Affairs for Boston Scientific Corporation, a medical device company. From January 2012 to March 2014, he held the position of Director Quality and Regulatory Affairs International for the American Medical Systems division of Endo International plc, a pharmaceutical company. From September 2003 to December 2011, Mr. Wijker held various regulatory affairs and quality assurance positions with Life Technologies Corporation, a life sciences and in vitro diagnostics company.
Mr. Winters has been our Corporate Vice President, Manufacturing and Supply Chain since February 2020. He previously held the position of Vice President, Global Manufacturing from March 2018 to January 2020. Prior to joining Teleflex, Mr. Winters held various senior management and operational roles with the DePuy Synthes division of Johnson & Johnson, a healthcare company, from August 2005 to February 2018. Most recently, Mr. Winters served as Vice President of Global Manufacturing for Global Joint Reconstruction for DePuy Synthes from February 2015 to February 2018. Prior to that, Mr. Winters served as Plant Manager for the DePuy Synthes Ireland Manufacturing Operation.
Our officers are elected annually by our board of directors. Each officer serves at the discretion of the board.

ITEM 1A. RISK FACTORS
In addition to the other information set forth in this Annual Report on Form 10-K, you should carefully consider the following factors which could have a material adverse effect on our business, financial condition, results of operations, cash flows or stock price. The risks below are not the only risks we face. Additional risks and uncertainties not currently known to us or that we currently deem to be immaterial may also adversely affect our business, financial condition, results of operations or stock price.
Risks Relating to our Business and Operations
We face strong competition. Our failure to successfully develop and market new products could adversely affect our business.
The medical device industry is highly competitive. We compete with many domestic and foreign medical device companies ranging from small start-up enterprises that might sell only a single or limited number of competitive products or compete only in a specific market segment, to companies that are larger and more established than us, have a broad range of competitive products, participate in numerous markets and have access to significantly greater financial and marketing resources than we do.
In addition, the medical device industry is characterized by extensive product research and development and rapid technological advances. The future success of our business will depend, in part, on our ability to design and manufacture new competitive products and enhance existing products. Our product development efforts may require us to make substantial investments. There can be no assurance that we will be able to successfully develop
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new products, enhance existing products or achieve market acceptance of our products, due to, among other things, our inability to:
identify viable new products;
maintain sufficient liquidity to fund our investments in research and development and product acquisitions;
obtain adequate intellectual property protection;
gain market acceptance of new products; or
successfully obtain regulatory approvals.
In addition, our competitors currently may be developing, or may develop in the future, products that provide better features, clinical outcomes or economic value than those that we currently offer or subsequently develop. Our failure to successfully develop and market new products or enhance existing products could have a material adverse effect on our business, financial condition and results of operations.
Our results of operations and financial condition may be adversely affected by public health epidemics, including the ongoing COVID-19 global health pandemic.
We are subject to risks associated with public health threats, including the ongoing COVID-19 pandemic. The COVID-19 pandemic has significantly impacted economic activity and markets around the world and has negatively impacted our operations, financial performance and cash flows. Because the severity, magnitude, and duration of the COVID-19 pandemic and its economic consequences are uncertain, rapidly changing and difficult to predict, the pandemic’s impact on our operations and financial performance, as well as its impact on our ability to execute our
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business strategies and initiatives successfully, remains uncertain and difficult to predict. Further, the ultimate impact of the COVID-19 pandemic on our operations and financial performance depends on many factors that are not within our control, including, but not limited, to: governmental, business and individuals’ actions that have been and continue to be taken in response to the pandemic (including restrictions on travel, transport and workforce pressures, and deferrals or postponements of elective procedures); the impact of the pandemic and actions taken in response on global and regional economies, travel and economic activity; the availability of federal, state, local or non-U.S. funding programs; general economic uncertainty in key global markets and financial market volatility; global economic conditions and levels of economic growth; and the timing and pace of recovery when the COVID-19 pandemic subsides, which could be impacted by a number of factors, including limited provider capacity to perform procedures using our products that were deferred as a result of the pandemic.
The COVID-19 pandemic has subjected, and is expected to continue to subject, our operations, financial performance and financial condition to a number of risks, including, but not limited to those discussed below:
It has resulted, and we expect it will continue to result, in lower revenues in certain of our product categories, including our interventional urology (which revenues are primarily concentrated in our Americas segment), surgical, interventional, anesthesia and OEM product categories, in which we sell products largely utilized in elective procedures, which have been significantly reduced or suspended due to the pandemic.
It has resulted in higher revenues in our respiratory and vascular access product categories. However, we are unable to predict how long this increased demand will last or how significant it will be.
It has caused and may continue to cause disruptions in the manufacture of our products. We currently rely on our 35 manufacturing sites, with major manufacturing operations located in the Czech Republic, Germany, Malaysia, Mexico and the U.S., to manufacture our products. The COVID-19 pandemic, and/or the governmental or regulatory actions taken in response to COVID-19 pandemic, may interfere with our ability, or that of our employees or suppliers to perform our and their respective responsibilities and obligations relative to the conduct of our business and create a risk to our ability to manufacture our products in a timely manner, or at all. We have experienced and expect to continue to experience inefficiencies in our manufacturing operations due to government-mandated and self-imposed restrictions placed on facilities in certain locations primarily in North America and Asia. Additionally, we have experienced and continue to experience a higher than normal level of absenteeism across our global manufacturing sites. In an effort to increase the wider availability of needed medical device products, we may elect to, or the government may require us to, allocate manufacturing capacity (for example, pursuant to the U.S. Defense Production Act) in a way that adversely affects our regular operations and financial results, results in differential treatment of customers and/or adversely affects our customer relationships and reputation.
While we have not experienced significant payment defaults by, or identified other significant collectability concerns with, our customers to date, we may be adversely impacted by delays in payments of outstanding receivables if our customers experience financial difficulties or are unable to borrow money to fund their operations, which may adversely impact their ability to pay for our products on a timely basis, if at all.
The COVID-19 pandemic, including related illness, border closures, travel restrictions, quarantines, lockdowns or other workforce disruptions, could disrupt our suppliers or our suppliers’ suppliers and/or the distribution of our products, whether through our direct sales force or our distributors. These disruptions, or our failure to respond to them, could increase manufacturing or distribution costs or cause delays in delivering, or an inability to deliver, products to our customers.
The COVID-19 pandemic has increased volatility and pricing in the capital markets, and volatility is likely to continue. We might not be able to continue to access preferred sources of liquidity when we would like, and our borrowing costs could increase.
These and other impacts of the COVID-19 pandemic, or other pandemics or epidemics, could have the effect of heightening many of the other risks described herein. We might not be able to predict or respond to all impacts on a timely basis to prevent near- or long-term adverse impacts to our results. However, these effects could have an adverse impact on our liquidity, capital resources, operations and business and those of the third parties on which we rely, and such impact could be material.
Our customers depend on third party coverage and reimbursements, and the failure of healthcare programs to provide sufficient coverage and reimbursement for our medical products could adversely affect us.
The ability of our customers to obtain coverage and reimbursement for our products is important to our business. Demand for many of our existing and new medical products is, and will continue to be, affected by the
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extent to which government healthcare programs and private health insurers reimburse our customers for patients’ medical expenses in the countries where we do business. Even when we develop or acquire a promising new product, demand for the product may be limited unless reimbursement approval is obtained from private and government third party payors. Internationally, healthcare reimbursement systems vary significantly. In some countries, medical centers are constrained by fixed budgets, regardless of the volume and nature of patient treatment. Other countries require application for, and approval of, government or third party reimbursement. Without both favorable coverage determinations by, and the financial support of, government and third party insurers, the market for many of our medical products would be adversely affected. In this regard, we cannot be sure that third party payors will maintain the current level of coverage and reimbursement to our customers for use of our existing products. Adverse coverage determinations, including reductions in the amount of reimbursement, could harm our business by discouraging customers’ selection of, and reducing the prices they are willing to pay for, our products.
In addition, as a result of their purchasing power, third party payors have implemented and are continuing to implement cost cutting measures such as seeking discounts, price reductions or other incentives from medical products suppliers and imposing limitations on coverage and reimbursement for medical technologies and procedures. These trends could compel us to reduce prices for our products and could cause a decrease in the size of the market or a potential increase in competition that could negatively affect our business, financial condition and results of operations.
We are subject to extensive government regulation, which may require us to incur significant expenses to ensure compliance. Our failure to comply with those regulations could have a material adverse effect on our business, results of operations, financial condition and cash flows.
Our products are medical devices and are subject to extensive regulation in the U.S. by the FDA and by comparable government agencies in other countries. The regulations govern, among other things, the development, design, clinical testing, premarket clearance and approval, manufacturing, labeling, importing and exporting and sale and marketing of many of our products. Moreover, these regulations are subject to future change.
In the U.S., before we can market a new medical device, or a new use of, or claim for, or significant modification to, an existing product, we generally must first receive either 510(k) clearance or de novo authorization or approval of a premarket approval application, or PMA, from the FDA. Similarly, most major markets for medical devices outside the U.S. also require clearance, approval, authorization or compliance with certain standards before a product can be commercially marketed. In the EU, the EU MDR will, when it enterswent into full forceeffect in May 2021 includeand includes significant additional pre- and post-market requirements. The process of obtaining regulatory clearances and approvals to market a medical device, particularly from the FDA and certain foreign government authorities, can be costly and time consuming, and clearances and approvals might not be granted for new products on a timely basis, if at all. In addition, once a device has been cleared or approved, a new clearance or approval may be required before the device may be modified or its labeling changed. Furthermore, the FDA or a foreign government authority may make its review and clearance or approval process more rigorous, which could require us to generate
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additional clinical or other data, and expend more time and effort, in obtaining future product clearances or approvals. The regulatory clearance and approval process may result in, among other things, delayed realization of product revenues, substantial additional costs or limitations on indicated uses of products, any one of which could have a material adverse effect on our financial condition and results of operations. Even after a product has received marketing approval or clearance, such product approval or clearance can be withdrawn or limited due to unforeseen problems with the device or issues relating to its application, or the FDA or a foreign government authority may change the classification of a product, which could require additional clinical studies and new marketing submissions.
Failure to comply with applicable regulations could lead to adverse effects on our business, which could include:
partial suspension or total shutdown of manufacturing;
product shortages;
delays in product manufacturing;
warning or untitled letters;
fines or civil penalties;
delays in or restrictions on obtaining new regulatory clearances or approvals;
withdrawal or suspension of required clearances, approvals or licenses;
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product seizures or recalls;
injunctions;
criminal prosecution;
advisories or other field actions;
operating restrictions; and
prohibitions against exporting of products to, or importing products from, countries outside the U.S.
We could be required to expend significant financial and human resources to remediate failures to comply with applicable regulations and quality assurance guidelines. In addition, civil and criminal penalties, including exclusion under Medicaid or Medicare, could result from certain regulatory violations. Any one or more of these events could have a material adverse effect on our business, financial condition and results of operations.
Medical devices are cleared or approved for one or more specific intended uses and performance claims must be adequately substantiated. Promoting a device for a use outside of the cleared or approved intended use or population, that is, an off-label use, or making false, misleading or unsubstantiated claims could result in government enforcement action.
Furthermore, our facilities are subject to periodic inspection by the FDA and other federal, state and foreign government authorities, which require manufacturers of medical devices to adhere to certain regulations, including the FDA’s Quality System Regulation ("QSR"), which requires, among other things, periodic audits, design controls, quality control testing and documentation procedures, as well as complaint evaluations and investigation. In addition, any facilities assembling kits that include drug components and are registered as drug repackaging establishments are also subject to current good manufacturing practices requirements for drugs. The FDA also requires the reporting of certain adverse events and product malfunctions and requires the reporting of certain recalls or other field safety corrective actions for medical devices. Issues identified through such inspections and reports may result in FDA enforcement action through any of the actions discussed above. Moreover, issues identified through such inspections and reports may require significant resources to resolve.
Our results of operations and financial condition may be adversely affected by public health epidemics, including the ongoing COVID-19 global health pandemic.
We are subject to risks associated with public health threats, such as the recent and ongoing COVID-19 pandemic. The COVID-19 pandemic significantly impacted economic activity and markets around the world and negatively impacted our operations, financial performance and cash flows. These effects continue, and their impact going forward is uncertain because the trajectory and nature of the pandemic remain uncertain and difficult to predict. Such effects depend on various factors, including, but not limited, to: the occurrence, spread, duration and severity of any subsequent wave or waves of outbreaks, including the emergence and spread of variants of the COVID-19 virus; governmental, business and individuals’ actions that have been and continue to be taken in response to the pandemic (including restrictions on travel, transport and workforce pressures, and deferrals or
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postponements of elective procedures); the impact of the pandemic and actions taken in response on global and regional economies, travel and economic activity; the availability of federal, state, local or non-U.S. funding programs; general economic uncertainty in key global markets and financial market volatility; global economic conditions and levels of economic growth; and the timing and pace of recovery when the COVID-19 pandemic subsides, which could be impacted by a number of factors, including limited provider capacity to perform procedures using our products that were deferred as a result of the pandemic.
With respect to our company, the COVID-19 pandemic has had, and may continue to have, an impact on our operations, financial performance and financial condition in several ways, including, but not limited to, those discussed below:
It has caused and may continue to cause disruptions in our manufacturing operations globally, which are subject to governmental or regulatory actions taken in response to COVID-19. These actions could impact our ability, or that of our employees or suppliers, to perform our and their respective responsibilities and obligations relative to the conduct of our business and create a risk to our ability to manufacture our products in a timely manner, or at all.
The effects of the pandemic have caused, and could in the future continue to cause, disruptions in our workforce and our global supply chain. These disruptions, or our failure to respond to them, could increase manufacturing or distribution costs or cause further delays in delivering, or an inability to deliver, products to our customers.
The effects of the pandemic have resulted, and could in the future continue to result, in lower revenues in certain of our product categories.
These and other impacts of the COVID-19 pandemic, or other pandemics or epidemics, could have the effect of heightening many of the other risks described herein. We might not be able to predict or respond to all impacts on a timely basis to prevent near- or long-term adverse impacts to our results. However, these effects could have an adverse impact on our liquidity, capital resources, operations and business and those of the third parties on which we rely, and such impact could be material.
We are subject to healthcare fraud and abuse laws, regulation and enforcement; our failure to comply with those laws could have a material adverse effect on our results of operations and financial condition.
We are subject to healthcare fraud and abuse regulation and enforcement by the federal government and the governments of those states and foreign countries in which we conduct our business. The laws that may affect our ability to operate include:
the federal healthcare anti-kickback statute, which, among other things, prohibits persons from knowingly and willfully offering or paying remuneration, one purpose of which is to induce either the referral of an individual for, or the purchase, order or recommendation of, any good or service for which payment may be made under federal healthcare programs such as Medicare and Medicaid, or soliciting payment for such referrals, purchases, orders and recommendations;
federal false claims laws which, among other things, prohibit individuals or entities from knowingly presenting, or causing to be presented, false or fraudulent claims for payment from the federal government, including Medicare, Medicaid or other third-party payors;
the federal Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), which prohibits schemes to defraud any healthcare benefit program and false statements relating to healthcare matters; and
state law equivalents of each of the above federal laws, such as anti-kickback and false claims laws which may apply to items or services reimbursed by any third-party payor, including commercial insurers.
If our operations are found to be in violation of any of these laws or any other government regulations, we may be subject to penalties, including civil and criminal penalties, damages, fines, the curtailment or restructuring of our operations, the exclusion from participation in federal and state healthcare programs and imprisonment of personnel, any of which could adversely affect our ability to operate our business and our financial results. The risk of our being found to have violated these laws is increased by the fact that many of them have not been fully interpreted by the regulatory authorities or the courts, and their provisions are open to a variety of interpretations.
Further, the Affordable Care Act, imposedthrough the Physician Payments Sunshine Act, imposes annual reporting and disclosure requirements on device manufacturers for any “transfer of value” made or distributed to physicians or teaching hospitals. Effective January 2022, we will also be required to collect and report information on payments or transfers of value tohospitals, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists (including anesthesiology assistants) and certified nurse-nurse-midwives. The reported information is made
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midwives. The reported information is made publicly available in a searchable format. In addition, device manufacturers are required to report and disclose any ownership or investment interests held by physicians and their immediate family members during the preceding calendar year. Failure to submit required information may result in civil monetary penalties for each payment, transfer of value or ownership or investment interests not reported in an annual submission, up to an aggregate of $150,000 per year (and up to an aggregate of $1 million per year for “knowing failures”).
There are also certain states, including Connecticut, Massachusetts, and Vermont, that require device manufacturers to track and report payments or transfers of value provided to certain health care providers and health care entities. In addition, there has been a recent trend of increased federal and state regulation of payments made to healthcare providers. Somesome states, such as California, Connecticut, Nevada and Massachusetts, mandate implementation of compliance programs that include restrictions on certain interactions and items of value that may be provided to health care providers, as well as the tracking and reporting of gifts,certain items of value, compensation for consulting and other services, and other remuneration to healthcare providers. Further, we are subject to a law in Vermont that imposes a ban on providing certain items of value and payments to health care providers. The shifting commercial compliance environment and the need to build and maintain robust and expandable systems to comply with the different compliance and/or reporting requirements among a number of jurisdictions increases the possibility that we may inadvertently violate one or more of the requirements, resulting in increased compliance costs that could adversely impact our results of operations.
We may not be successful in achieving expected operating efficiencies and sustaining or improving operating expense reductions, and may experience business disruptions associated with restructuring, facility consolidations, realignment, cost reduction and other strategic initiatives.
Over the past several years we have implemented a number of restructuring, realignment and cost reduction initiatives, including facility consolidations, organizational realignments and reductions in our workforce, and we may engage in similar efforts in the future. While we have realized some efficiencies from these initiatives, we may not realize the benefits of these or future initiatives to the extent we anticipated. Further, such benefits may be realized later than expected, and the ongoing difficulties in implementing these measures may be greater than anticipated, which could cause us to incur additional costs or result in business disruptions. In addition, if these measures are not successful or sustainable, we may be compelled to undertake additional restructuring, realignment and cost reduction efforts, which could result in significant additional charges. Moreover, if our restructuring, realignment and cost reduction efforts prove ineffective, our ability to achieve our strategic and business plan goals may be adversely affected.
In addition, as part of our efforts to increase operating efficiencies, we have implemented a number of initiatives over the past several years to consolidate our enterprise resource planning, or ERP, systems. Most recently, we upgraded the ERP system used by our EMEA segment to our global ERP system in 2019. To date, we have not experienced any significant disruptions to our business or operations in connection with these initiatives. However, as we continue our efforts to further consolidate our ERP systems, we could experience business disruptions, which could adversely affect customer relationships and divert the attention of management away from daily operations. In addition, any delays in the implementation of these initiatives could cause us to incur additional unexpected costs. Should we experience such difficulties, our business, cash flows and results of operations could be adversely affected.
Disruptions in sterilization of our products or regulatory initiatives further restricting the use of ethylene oxide in sterilization facilities could adversely affect our results of operations and financial condition.
Many of our products require sterilization prior to sale. A common method for sterilizing medical products involves the use of ethylene oxide, which is listed as a hazardous air pollutant under the Clean Air Act, as amended, and emissions of which are regulated by the U.S. Environmental Protection Agency ("EPA") and other regulatory authorities. Companies in the sterilization industry may face private litigation that could result in financial difficulties that could ultimately make it difficult or undesirable for such companies to continue in the sterilization business. In addition, sterilization activities are subject to substantial governmental oversight and attention that could disrupt their operations. One of our contract sterilizers, Sterigenics U.S., LLC, uses ethylene oxide in its sterilization process, including at its facilities in Smyrna, Cobb County, Georgia and Santa Teresa, New Mexico, which have sterilized some of our vascular, surgical, intermittent catheter and OEM products. During the fourth quarter of the year ended December 31, 2019, operations at the Smyrna facility were suspended by state and local officials due to issues associated with the facility's use of ethylene oxide in its sterilization operations, but have since reopened. In December 2020, the New Mexico Attorney General initiated legal proceedings involving the Santa Teresa facility, alleging that its operations have resulted in impermissible ethylene oxide emissions. While both plants are currently operating normally, should their operations be suspended or adversely affected, our ability to provide affected
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products to our customers could be impaired if we are unable to utilize alternate facilities and sources for sterilization services.
In addition, on October 10, 2019, the attorneys general of 15 states and the District of Columbia sent a letter to the EPA urging that the EPA promptly propose and finalize stricter standards for ethylene oxide emissions. Among
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other things, the attorneys general stated that the current EPA standard for ethylene oxide fails to adequately protect workers and communities, and that the use of ethylene oxide, particularly in the medical device sterilization industry, must be reduced. We are unable to predict the manner in whichOn December 12, 2019, the EPA issued an Advance Notice of Proposed Rulemaking to solicit information and request comments that will respondaid in the EPA’s future revisions of the regulations concerning ethylene oxide omissions. Subsequently, on September 13, 2021, the EPA issued an information collection request to commercial sterilization facilities to gather additional information and data about ethylene oxide sterilization processes and emissions. The EPA has indicated it expects to issue proposed regulations for commercial sterilizers in the letter.near term. Any additional regulatory restrictions on the emission of ethylene oxide by sterilization facilities might impair our ability to provide sufficient quantities of sterilized products to our customers and compel us to seek sterilization alternatives that do not entail the use of ethylene oxide. We cannot assure that we would be able to identify such alternatives.
In the event we were to experience any further disruptions in our ability to sterilize our products, whether due to capacity constraints or regulatory or other impediments (including, among other things, regulatory initiatives directed generally to sterilization facilities that utilize ethylene oxide), or we are unable to transition to alternative facilities in a timely or cost effective manner in the event one or more of the facilities we use is affected, we could experience a material adverse impact with respect to our results of operations and financial condition.
A significant portion of our U.S. revenues is derived from sales to distributors, and “destocking” activity by these distributors can adversely affect our revenues and results of operations.
A significant portion of our revenues in the U.S. is derived from sales to distributors, which, in turn, sell our products to hospitals and other health care institutions. From time to time, these distributors may decide to reduce their levels of inventory with regard to certain of our products, a practice we refer to as “destocking.” A distributor's decision to reduce inventory levels with respect to our products may be based on a number of factors, such as distributor expectations regarding demand for a particular product, distributor buying decisions (including decisions to purchase competing products), changes in distributor policies regarding the maintenance of inventory levels, economic conditions and other factors. For example, during the third quarter of 2016, we experienced a decline in purchases by our U.S. distributors that adversely affected our revenues and results of operations. We believe the reduction resulted from the distributors' expectations of a less severe 2016-2017 flu season, which resulted in reduced levels of purchasing with respect to certain of our products that are used for treatment of hospitalized patients suffering from the flu. Following such instances of reduced purchases, distributors may revert to previous purchasing levels; nevertheless, we cannot assure that distributors will, in fact, increase purchases of our products in this manner. A decline in the level of product purchases by our U.S. distributors in the future could have a material adverse effect on our revenues and results of operations during a reporting period, and an extended decline in such product purchases could have a longer term material adverse effect.
We may incur material losses and costs as a result of product liability and warranty claims, as well as product recalls, any of which may adversely affect our results of operations and financial condition. Furthermore, our reputation as a medical device company may be damaged if one or more of our products are, or are alleged to be, defective.
Our businesses expose us to potential product liability risks related to the design, manufacture, labeling and marketing of our products. In particular, our medical device products are often used in surgical and intensive care settings for procedures involving seriously ill patients. In addition, many of our products are designed to be implanted in the human body for varying periods of time. Product defects or inadequate disclosure of product-related risks with respect to products we manufacture or sell could result in patient injury or death. Product liability and warranty claims often involve very large or indeterminate amounts, including punitive damages. The magnitude of potential losses from product liability lawsuits may remain unknown for substantial periods of time, and the related legal defense costs may be significant. We could experience material warranty or product liability losses in the future and incur significant costs to defend these claims.
In addition, if any of our products are, or are alleged to be, defective, we may voluntarily conduct, or be required by regulatory authorities to conduct, a recall of that product. In the event of a recall, we may lose sales and be exposed to individual or class-action litigation claims. Moreover, negative publicity regarding a quality or safety issue, whether accurate or inaccurate, could harm our reputation, decrease demand for our products, lead to product withdrawals or impair our ability to successfully launch and market our products in the future. Product liability, warranty and recall costs may have a material adverse effect on our business, financial condition, results of operations and cash flows.
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Volatility in domestic and global financial markets could adversely impact our results of operations, financial condition and liquidity.
We are subject to risks arising from adverse changes in general domestic and global economic conditions. The economic slowdown and disruption of credit markets that occurred several years ago led to recessionary conditions and depressed levels of consumer and commercial spending, resulting in reductions, delays or cancellations of
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purchases of our products and services. We cannot predict the duration or extent of any economic recovery or the extent to which our customers will return to more typical spending behaviors. The continuation in a number of markets of weak economic growth, constricted credit, public sector austerity measures in response to public budget deficits and foreign currency volatility, particularly with respect to the euro, could have a material adverse effect on our results of operations, financial condition and liquidity.
Although we maintain allowances for doubtful accounts to cover the estimated losses which may occur when customers cannot make their required payments, we cannot assure that the loss rate will not increase in the future given the volatility in the worldwide economy. If our allowance for doubtful accounts is insufficient to address receivables we ultimately determine are uncollectible, we would be required to incur additional charges, which could materially adversely affect our results of operations. Moreover, our inability to collect outstanding receivables could adversely affect our financial condition and cash flow from operations.
In addition, adverse economic and financial market conditions may result in future impairment charges with respect to our goodwill and other intangible assets, which would not directly affect our liquidity but could have a material adverse effect on our reported financial results.
Our strategic initiatives, including acquisitions, may not produce the intended growth in revenue and operating income, which could have a material adverse effect on our operating results.
Our strategic initiatives include making significant investments designed to achieve revenue growth and to enable us to meet or exceed margin improvement targets. If we do not achieve the expected benefits from these investments or otherwise fail to execute on our strategic initiatives, we may not achieve the growth improvement we are targeting, and our results of operations may be adversely affected.
In addition, as part of our strategy for growth, we have made, and may continue to make, acquisitions and divestitures and enter into strategic alliances such as joint ventures and joint development agreements. However, we may not be able to identify suitable acquisition candidates, complete acquisitions or integrate acquisitions successfully, and our joint ventures or strategic alliances may not prove to be successful. In this regard, acquisitions involve numerous risks, including difficulties in the integration of acquired operations, technologies, services and products and the diversion of management’s attention from other business concerns. Moreover, the products and technologies that we acquire may not be successful or may require us to devote significantly greater development, marketing and other resources, as well as significantly greater investments, than we anticipated. We could also experience negative effects on our results of operations and financial condition from acquisition-related charges, amortization of intangible assets, asset impairment charges and other matters that could arise in connection with the acquisition of a company or business, including matters related to internal control over financial reporting and regulatory compliance, as well as the short-term effects of increased costs on results of operations.  Although our management will endeavor to evaluate the risks inherent in any particular transaction, there can be no assurance that we will identify all such risks or the magnitude of the risks. In addition, prior acquisitions have resulted, and future acquisitions could result, in the incurrence of substantial additional indebtedness and expenditures. Future acquisitions may also result in potentially dilutive issuances of equity securities. There can be no assurance that difficulties encountered in connection with acquisitions will not have a material adverse effect on our business, financial condition and results of operations.
In connection with certain of our completed acquisitions, we have agreed to pay consideration that is contingent upon the achievement of specified objectives, such as receipt of regulatory approval, commercialization of a product or achievement of sales targets. As of the acquisition date, we record a contingent liability representing the estimated fair value of the contingent consideration we expect to pay. On a quarterly basis, we reassess these obligations and, in the event our estimate of the fair value of the contingent consideration changes, we record increases or decreases in the fair value as an adjustment to operating earnings, which could have a material impact on our results of operations. As of December 31, 2020,2022, we accrued $36.6$44.0 million of contingent consideration related to completed business combinations, most of which related to our acquisition of Essential Medical.Standard Bariatrics. In addition, actual payments may differ materially from the amount of the contingent liability, , which could have a material impact on our results of operations, cash flows and liquidity. For information regarding assumptions related to our contingent consideration liabilities, see “Critical Accounting Policies and Estimates” under Item 7, Management’s Discussion and Analysis of
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Financial Condition and Results of Operations included in this Annual Report on Form 10-K. For additional information regarding our acquisitions, see Note 4 to the consolidated financial statements included in this Annual Report on Form 10-K.
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Health care reform may have a material adverse effect on our industry and our business.
Political, economic and regulatory developments have effected fundamental changes in the healthcare industry. The Affordable Care Act substantially changed the way health care is financed by both government and private insurers. It also encourages improvements in the quality of health care products and services and significantly impacts the U.S. pharmaceutical and medical device industries. Among other things, the Affordable Care Act:
established a new Patient-Centered Outcomes Research Institute to oversee, identify priorities in and conduct comparative clinical effectiveness research;
implemented payment system reforms, including a national pilot program to encourage hospitals, physicians and other providers to improve the coordination, quality and efficiency of certain health care services through bundled payment models; and
created an independent payment advisory board that will submit recommendations to reduce Medicare spending if projected Medicare spending exceeds a specified growth rate.
We cannot predict at this time the full impact of the Affordable Care Act or other healthcare reform measures that may be adopted in the future on our financial condition, results of operations and cash flows. In this regard, several legislative initiatives to repeal and replace the Affordable Care Act were proposed, but not adopted in 2017. However, U.S. tax legislation adopted in December 2017 and commonly referred to as the Tax Cuts and Jobs Act ("TCJA") eliminated the individual mandate under the Affordable Care Act, which has resulted in increased uncertainty regarding insurance premium prices for participants in insurance exchanges under the act, and may have other effects. Moreover, on December 14, 2018, the U.S. District Court for the Northern District of Texas ruled that the individual mandate provision of the Affordable Care Act is unconstitutional and the remainder of the act is invalid, although the Court stayed its ruling pending appeal. The nature and effect of any modification or repeal of, or legislative substitution for, the Affordable Care Act, or any court decision regarding the act's validity, is uncertain, and we cannot predict the effect that any of these events would have on the longer-term viability of the act, or on our financial condition, results of operations or cash flows.
We are subject to risks associated with our non-U.S. operations.
We have significant manufacturing and distribution facilities, research and development facilities, sales personnel and customer support operations in a number of countries outside the U.S., including Belgium, the Czech Republic, Germany, Ireland, Malaysia and Mexico. In addition, a significant portion of our non-U.S. revenues are derived from sales to third party distributors. As of December 31, 2020,2022, approximately 70%75% of our full-time employees were employed in countries outside of the U.S., and approximately 50%55% of our net property, plant and equipment was located outside the U.S. In addition, for the years ended December 31, 2022, 2021 and 2020, 201936%, 37% and 2018, 38%, 38% and 41%, respectively, of our net revenues (based on the Teleflex entity generating the sale) were derived from operations outside the U.S.
Our international operations are subject to risks inherent in doing business outside the U.S., including:
exchange controls, currency restrictions and fluctuations in currency values;
trade protection measures, tariffs and other duties, especially in light of trade disputes between the U.S. and several foreign countries, including China;
potentially costly and burdensome import or export requirements;
laws and business practices that favor local companies;
changes in foreign medical reimbursement policies and procedures;
subsidies or increased access to capital for firms that currently are or may emerge as competitors in countries in which we have operations;
substantial non-U.S. tax liabilities, including potentially negative consequences resulting from changes in tax laws;
restrictions and taxes related to the repatriation of non-U.S. earnings;
differing labor regulations;
additional U.S. and foreign government controls or regulations;
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the impact of the United Kingdom's departure from the European Union, commonly referred to as "Brexit";
public health epidemics;
difficulties in the protection of intellectual property; and
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unsettled political and economic conditions and possible terrorist attacks against American interests.
In addition, the U.S. Foreign Corrupt Practices Act (the “FCPA”) prohibits companies and their intermediaries from making improper payments to non-U.S. officials for the purpose of obtaining or retaining business. Similar anti-bribery laws are in effect in several foreign jurisdictions. The FCPA also imposes accounting standards and requirements on publicly traded U.S. corporations and their foreign affiliates, which, among other things, are intended to prevent the diversion of corporate funds to the payment of bribes and other improper payments to government officials, and to prevent the establishment of “off the books” slush funds from which such improper payments can be made. Because of the predominance of government-sponsored health care systems around the world, many of our customer relationships outside of the U.S. are with government entities and are therefore subject to such anti-bribery laws. Our policies mandate compliance with these anti-bribery laws. However, we operate in many parts of the world that have experienced government corruption to some degree. Despite meaningful measures that we undertake to facilitate lawful conduct, which include training and compliance programs and internal control policies and procedures, we may not always prevent reckless or criminal acts by our employees, distributors or other agents. In addition, we may be exposed to liability due to pre-acquisition conduct of employees, distributors or other agents of businesses or operations we acquire. Violations of anti-bribery laws, or allegations of such violations, could disrupt our operations, involve significant management distraction and have a material adverse effect on our business, financial condition, results of operations and cash flows. We also could be subject to severe penalties and other adverse consequences, including criminal and civil penalties, disgorgement, substantial expenditures related to further enhancements to our procedures, policies and controls, personnel changes and other remedial actions, as well as harm to our reputation.
Furthermore, we are subject to the export controls and economic embargo rules and regulations of the U.S., including the Export Administration Regulations and trade sanctions against embargoed countries, which are administered by the Office of Foreign Assets Control within the Department of the Treasury, as well as other laws and regulations administered by the Department of Commerce. These regulations limit our ability to market, sell, distribute or otherwise transfer our products or technology to prohibited countries or persons. While we train our employees and contractually obligate our distributors to comply with these regulations, we cannot assure that a violation will not occur, whether knowingly or inadvertently. Failure to comply with these rules and regulations may result in substantial civil and criminal penalties, including fines and the disgorgement of profits, the imposition of a court-appointed monitor, the denial of export privileges and debarment from participation in U.S. government contracts, any of which could have a material adverse effect on our international operations or on our business, results of operations, financial condition and cash flows.
Additionally, in connection with the ongoing conflict between Russia and Ukraine, the U.S. government has imposed enhanced export controls on certain products and sanctions on certain industry sectors and parties in Russia. Although our sales into Russia did not constitute a material portion of our total revenue in 2022, further escalation of geopolitical tensions, including as a result of the imposition of additional economic sanctions, could have a broader impact that expands into other markets where we do business, which could adversely affect our business and/or our supply chain, business partners or customers in the broader region.
Foreign currency exchange rate, commodity price and interest rate fluctuations may adversely affect our results.
We are exposed to a variety of market risks, including the effects of changes in foreign currency exchange rates, commodity prices and interest rates. Products manufactured in, and sold into, foreign markets represent a significant portion of our operations. Our consolidated financial statements reflect translation of financial statements denominated in non-U.S. currencies to U.S. dollars, our reporting currency, as well as the foreign currency exchange gains and losses resulting from the remeasurement of assets and liabilities and from transactions denominated in currencies other than the primary currency of the country in which the entity operates, which we refer to as "non-functional currencies." A strengthening or weakening of the U.S. dollar in relation to the foreign currencies of the countries in which we sell or manufacture our products, such as the euro, will affect our U.S. dollar-reported revenue and income. Although we have entered into forward contracts with several major financial institutions to hedge a portion of our monetary assets and liabilities and projected cash flows denominated in non-functional currencies in order to reduce the effects of currency rate fluctuations, changes in the relative values of currencies may, in some instances, have a significant effect on our results of operations.
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Many of our products have significant plastic resin content. We also use quantities of other commodities, such as aluminum and steel. Increases in the prices of these commodities could increase the costs of our products and services. We may not be able to pass on these costs to our customers, particularly with respect to those products we sell under group purchase agreements, which could have a material adverse effect on our results of operations and cash flows.
Increases in interest rates may adversely affect the financial health of our customers and suppliers, thereby adversely affecting their ability to buy our products and supply the components or raw materials we need. In addition, our borrowing costs have been adversely affected by recent interest rate increases and could be further affected if interest rates continue to increase. Any of these events could have a material adverse effect on our financial condition, results of operations and cash flows.
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Fluctuations in our effective tax rate and changes to tax laws may adversely affect us.
As a global company, we are subject to taxation in numerous countries, states and other jurisdictions. Our effective tax rate is derived from a combination of applicable tax rates in the various countries, states and other jurisdictions in which we operate. In preparing our financial statements, we estimate the amount of tax that will become payable in each of these jurisdictions. Our effective tax rate may, however, differ from the estimated amount due to numerous factors, including a change in the mix of our profitability from country to country and changes in tax laws. Any of these factors could cause us to experience an effective tax rate significantly different from previous periods or our current expectations, which could have an adverse effect on our business, financial condition, results of operations and cash flows.
An interruption in our manufacturing or distribution operations or our supply of raw materials may adversely affect our business.
Many of our key products are manufactured at or distributed from single locations, and the availability of alternate facilities is limited. If operations at one or more of our facilities is suspended due to natural disasters or other events, including, without limitation, those due to climate change, we may not be able to timely manufacture or distribute one or more of our products at previous levels or at all. Furthermore, our ability to establish replacement facilities or to substitute suppliers may be delayed due to regulations and requirements of the FDA and other regulatory authorities regarding the manufacture of our products. In addition, in the event of delays or cancellations in shipments of raw materials by our suppliers, we may not be able to timely manufacture or supply the affected products at previous levels or at all. The manufacture of our products is highly exacting and complex, due in part to strict regulatory requirements. Problems in the manufacturing process, including equipment malfunction, failure to follow specific protocols and procedures, defective raw materials and environmental factors, could lead to delays in product releases, product shortages, unanticipated costs, lost revenues and damage to our reputation. A failure to identify and address manufacturing problems prior to the release of products to our customers may also result in quality or safety issues.  A reduction or interruption in manufacturing or distribution, or our inability to secure suitable alternative sources of raw materials or components, could have a material adverse effect on our business, results of operations, financial condition and cash flows.
Our ability to attract, train, develop and retain key employees is important to our success.
Our success depends, in part, on our ability to continue to retain key personnel, including our executive officers and other members of our senior management team. Our success also depends, in part, on our ability to attract, train, develop and retain other key employees, including research and development, sales, marketing and operations personnel. We may experience difficulties in retaining executives and other employees due to many factors, including:
the intense competition for skilled personnel in our industry;
fluctuations in global economic and industry conditions;
changes in our organizational structure;
our restructuring initiatives;
competitors’ hiring practices; and
the effectiveness of our compensation programs.
Our inability to attract, train, develop and retain such personnel could have an adverse effect on our business, results of operations, financial condition and cash flows.
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Our failure to maintain strong relationships with physicians and other health care professionals could adversely affect us.
We depend on our ability to maintain strong working relationships with physicians and other healthcare professionals in connection with research and development for some of our products. We rely on these professionals to provide us with considerable knowledge and advice regarding the development and use of these products. Physicians assist us as researchers, product consultants, inventors and public speakers. If we fail to maintain our working relationships with physicians and, as a result, no longer have the benefit of their knowledge and advice, our products may not be developed in a manner that is responsive to the needs and expectations of the professionals who use and support our products, which could have a material adverse effect on our business, financial condition, results of operations and cash flows.
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Our technology is important to our success, and our failure to protect our intellectual property rights could put us at a competitive disadvantage.
We rely on the patent, trademark, copyright and trade secret laws of the U.S. and other countries to protect our proprietary rights. Although we own numerous U.S. and foreign patents and have submitted numerous patent applications, we cannot be assured that any pending patent applications will issue, or that any patents, issued or pending, will provide us with any competitive advantage or will not be challenged, invalidated or circumvented by third parties. In addition, we rely on confidentiality and non-disclosure agreements with employees and take other measures to protect our know-how and trade secrets. The steps we have taken may not prevent unauthorized use of our technology by competitors or other persons who may copy or otherwise obtain and use these products or technology, particularly in foreign countries where the laws may not protect our proprietary rights to the same extent as in the U.S. We cannot assure that current and former employees, contractors and other parties will not breach their confidentiality agreements with us, misappropriate proprietary information, copy or otherwise obtain and use our information and proprietary technology without authorization or otherwise infringe on our intellectual property rights. Our inability to protect our proprietary technology could adversely affect our business, financial condition, results of operations and cash flows. Moreover, there can be no assurance that others will not independently develop know-how and trade secrets comparable to ours or develop better technology than our own, which could reduce or eliminate any competitive advantage we have developed.
Our products or processes may infringe the intellectual property rights of others, which may cause us to pay unexpected litigation costs or damages or prevent us from selling our products.
We cannot be certain that our products do not and will not infringe issued patents or other intellectual property rights of third parties. We may be subject to legal proceedings and claims in the ordinary course of our business, including claims of alleged infringement of the intellectual property rights of third parties. Any such claims, whether or not meritorious, could result in litigation and divert the efforts of our personnel. If we are found liable for infringement, we may be compelled to enter into licensing agreements (which may not be available on acceptable terms or at all) or to pay damages or cease making or selling certain products. We may need to redesign some of our products or processes to avoid future infringement liability. Any of the foregoing events could be detrimental to our business.
Other pending and future litigation may involve significant costs and adversely affect our business.
We are party to various lawsuits and claims arising in the normal course of business involving, among other things, contracts, intellectual property, import and export regulations, and employment and environmental matters. The defense of these lawsuits may divert our management’s attention and may involve significant legal expenses. In addition, we may be required to pay damage awards or settlements, or become subject to injunctions or other equitable remedies, that could have a material adverse effect on our financial condition and results of operations. While we do not believe that any litigation in which we are currently engaged would have such an adverse effect, the outcome of litigation, including regulatory matters, is often difficult to predict, and we cannot assure that the outcome of pending or future litigation will not have a material adverse effect on our business, financial condition, results of operations or cash flows.
Disruption of critical information systems or material breaches in the security of our systems may adversely affect our business and customer relationships.
We rely on information technology systems to process, transmit, and store electronic information in our day-to-day operations. We also rely on our technology infrastructure, among other functions, to enable us to interact with customers and suppliers, fulfill orders, generate invoices, collect and make payments, ship products, provide support to customers, fulfill contractual obligations and otherwise perform business functions. Our internal
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information technology systems, as well as those systems maintained by third-party providers, may be subjected to computer viruses or other malicious codes, unauthorized access attempts, and cyber-attacks, any of which could result in data leaks or otherwise compromise our confidential or proprietary information and disrupt our operations. Cyber-attacks are becoming more sophisticated and frequent, and in some cases have caused significant harm. Although we have taken numerous measures to protect our information systems and enhance data security, we cannot assure that these measures will prevent security breaches that could have a significant impact on our business, reputation and financial results. If we fail to monitor, maintain or protect our information technology systems and data integrity effectively or fail to anticipate, plan for or manage significant disruptions to these systems, we could, among other things, lose customers, have difficulty preventing fraud, have disputes with customers, physicians and other health care professionals, be subject to regulatory sanctions or penalties, incur
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expenses, lose revenues or suffer other adverse consequences. Any of these events could have a material adverse effect on our business, results of operations, financial condition or cash flows.
Regulations related to conflict minerals have caused us to incur additional costs and may adversely affect our business.
In 2012, the SEC promulgated rules under the Dodd-Frank Wall Street Reform and Consumer Protection Act regarding disclosure of the use of tin, tantalum, tungsten and gold, known as "conflict minerals," included in components of products either manufactured by public companies or for which public companies have contracted to manufacture. These rules require that we undertake due diligence efforts to determine whether such minerals originated from the Democratic Republic of Congo (the “DRC”) or an adjoining country and, if so, whether such minerals helped finance armed conflict in the DRC or an adjoining country. In accordance with applicable regulations, we have filed conflict minerals reports annually, beginning in 2014.As discussed in these reports, we have determined that certain of our products contain the specified minerals, and we have undertaken, and continue to undertake, efforts to identify where such minerals originated. We have incurred, and expect to continue to incur, costs associated with complying with these disclosure requirements, including costs related to determining the sources of the specified minerals used in our products. These rules could adversely affect the sourcing, supply and pricing of materials used in our products. Our customers may require that our products be free of conflict minerals, and our revenues and margins may be adversely affected if we are unable to provide assurances to our customers that our products are “DRC conflict free” (generally, the product does not contain conflict minerals originating in the DRC or an adjoining country that directly or indirectly finance or benefit specified armed groups) due to, among other things, our inability to procure conflict free minerals at a reasonable price, or at all.Moreover, we may be adversely affected if we are unable to pass through any increased costs associated with meeting customer demands that we provide products that are DRC conflict free. We also may face reputational challenges if our due diligence efforts do not enable us to verify the origins of all conflict minerals or to determine that any conflict minerals used in products we manufacture or in products manufactured by others for us are DRC conflict-free.
Our operations expose us to the risk of material environmental and health and safety liabilities.
We are subject to numerous foreign, federal, state and local environmental protection and health and safety laws governing, among other things:
the generation, storage, use and transportation of hazardous materials;
emissions or discharges of substances into the environment;
the impacts of industrial operations on climate change; and
the health and safety of our employees.
These laws and regulations are complex, change frequently and have tended to become more stringent over time. We cannot provide assurance that our costs of complying with current or future environmental protection and health and safety laws, or our liabilities arising from past or future releases of, or exposures to, hazardous substances, which may include claims for personal injury or cleanup, will not exceed our estimates or will not adversely affect our financial condition and results of operations.
The effects of climate change or legal, regulatory or market measures intended to address climate change could adversely affect our business, results of operations, financial condition and cash flows.
Risks associated with climate change are subject to increasing societal, regulatory and political focus in the U.S. and globally. While the effects of climate change in the near- and long-term are difficult to predict, shifts in weather patterns caused by climate change are expected to increase the frequency, severity and duration of certain adverse weather conditions and natural disasters, such as hurricanes, tornadoes, earthquakes, wildfires, droughts, extreme temperatures or flooding, which could cause more significant business and supply chain interruptions, damage to our products and facilities as well as the infrastructure of hospitals, medical care facilities and other customers, reduced workforce availability, increased costs of raw materials and components, increased liabilities, and decreased revenues than what we have experienced in the past from such events. In addition, increased public concern over climate change could result in new legal or regulatory requirements designed to mitigate the effects of climate change, which could include the adoption of more stringent environmental laws and regulations or stricter enforcement of existing laws and regulations, which could result in increased compliance burdens and costs to meet the regulatory obligations as well as adverse impacts on raw material sourcing, manufacturing operations and the distribution of our products. Any such developments could have a material adverse effect on our business, results of operations, financial condition and cash flows.
Our workforce covered by collective bargaining and similar agreements could cause interruptions in our provision of products and services.
As of December 31, 2020, approximately 8%2022, 9% of our employees in the U.S. and in other countries were covered by union contracts or collective bargaining arrangements. It is likely that a portion of our workforce will remain covered by collective bargaining and similar agreements for the foreseeable future. Strikes or work stoppages could occur that would adversely impact our relationships with our customers and our ability to conduct our business.
Risks Relating to our Financing Arrangements
Our substantial indebtedness could adversely affect our business, financial condition or results of operations.
As of December 31, 2020,2022, we had total consolidated indebtedness of $2.5$1.7 billion.
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Our substantial level of indebtedness increases the risk that we may be unable to generate cash sufficient to satisfy our debt obligations. It could also have significant effects on our business. For example, it could:
increase our vulnerability to general adverse economic and industry conditions;
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require us to dedicate a substantial portion of our cash flow from operations to payments on our indebtedness, thereby reducing the availability of our cash flow to fund capital expenditures, research and development efforts and other general corporate expenditures;
limit our ability to borrow additional funds for general corporate purposes;
limit our flexibility in planning for, or reacting to, changes in our business and the industry in which we operate;
restrict us from pursuing business opportunities; and
place us at a disadvantage compared to competitors that have less indebtedness.
If we do not generate sufficient cash flow from operations or if future borrowings are not available to us in an amount sufficient to pay our indebtedness when due or to fund our other liquidity needs, we may be forced to:
refinance all or a portion of our indebtedness;
sell assets;
reduce or delay capital expenditures; or
seek to raise additional capital.
We may not be able to effect any of these actions on commercially reasonable terms or at all. Our ability to refinance our indebtedness will depend on our financial condition at the time, the restrictions in the instruments governing our outstanding indebtedness and other factors, including market conditions.
Our inability to generate sufficient cash flow to satisfy our debt service obligations, or to refinance or restructure our obligations on commercially reasonable terms or at all, could have a material adverse effect on our business, financial condition and results of operations.
Our debt agreements impose restrictions on our business, which could prevent us from pursuing business opportunities and taking other desirable corporate actions, and may adversely affect our ability to respond to changes in our business and manage our operations.
Our senior credit agreement and the indentures governing our 4.875% senior notes due 2026 (the "2026 Notes") and our 4.625% senior notes due 2027 (the "2027 Notes") and our 4.25% Senior Notes due 2028 (the "2028 Notes" and, together with the 20262027 Notes, the "Senior Notes") contain covenants that, among other things, impose significant restrictions on our business. The restrictions that these covenants place on us and our restricted subsidiaries collectively include limitations on our and their ability to, among other things:
incur additional indebtedness or issue preferred stock or otherwise disqualified stock;
create liens;
pay dividends, make investments or make other restricted payments;
sell assets;
merge, consolidate, sell or otherwise dispose of all or substantially all of our assets; and
enter into transactions with our affiliates.
In addition, our senior credit agreement also contains financial covenants, including covenants requiring maintenance of a consolidated leverage ratio, a secured leverage ratio and a consolidated interest coverage ratio, calculated in accordance with the terms of the senior credit agreement. A breach of any covenants under any one or more of our debt agreements could result in a default, which if not cured or waived, could result in the acceleration of all of our debt. In addition, any debt agreements we enter into in the future may further limit our ability to enter into certain types of transactions.
Under our cross-currency swap agreements, a meaningful decline in the U.S. dollar to euro exchange rate could have a material adverse effect on our cash flows.
In 2018 and 2019, we entered into cross-currency swap agreements with several financial institutions to hedge against the effect of variability in the U.S. dollar to euro exchange rate. The swap agreements require an exchange of the notional amounts between us and the counterparties upon expiration or earlier termination of the agreements. If, at the expiration or earlier termination of the swap agreements, the U.S. dollar to euro exchange rate has
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declined from the rate in effect on the execution date, we are required to pay the counterparties an amount equal to the excess of the U.S. dollar value over the euro principal amount (we and the counterparties have agreed to a net settlement with regard to the exchange of the notional amounts at the date of expiration or earlier termination of the
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agreements). In the event of a significant decline in the U.S. dollar to euro exchange rate, our payment obligations to the counterparties could have a material adverse effect on our cash flows. In this regard, if, at the expiration or earlier termination of our swap agreements, the U.S. dollar to euro exchange rate has declined by 10% from the rate in effect at the inception of our agreements, we would be required to pay approximately $75 million to the counterparties in respect of the notional settlement. To the extent we enter into additional cross-currency swap agreements, a decline in the relevant exchange rates could further adversely affect our cash flows.
Risks Relating to Ownership of our Common Stock
We may issue additional shares of our common stock or instruments convertible into our common stock, which could cause the price of our common stock to decline.
We are not restricted from issuing additional shares of our common stock or other instruments convertible into our common stock. As of December 31, 2020,2022, we had outstanding approximately 46.746.9 million shares of our common stock, options to purchase 1.2 million shares of our common stock (of which approximately 0.91.0 million were vested as of that date), restricted stock units covering 0.2 million shares of our common stock (which are expected to vest over the next three years), performance stock units covering a maximum of 64,56262,927 shares of our common stock (which may vest in early 2021,2023, depending on our performance with regard to specified financial measures and market performance of our common stock compared to designated public companies) and 1,391123 shares of our common stock to be distributed from our deferred compensation plan. As of December 31, 2020, 3.22022, 2.8 million shares of our common stock were reserved for issuance upon the exercise of stock options. We cannot predict the size of future issuances or the effect, if any, that they may have on the market price for our common stock.
If we issue additional shares of our common stock or instruments convertible into our common stock, such issuances may materially and adversely affect the price of our common stock. Furthermore, our issuance of shares upon the exercise of some or all of the outstanding stock options, as well as the vesting of restricted stock units and some or all of the performance stock units will dilute the ownership interests of existing stockholders, and the subsequent sale in the public market of such shares of our common stock could adversely affect prevailing market prices of our common stock.
We may not pay dividends on our common stock in the future.
Holders of our common stock are entitled to receive dividends only as our board of directors may declare out of funds legally available for such payments. The declaration and payment of future dividends to holders of our common stock will be at the discretion of our board of directors and will depend upon many factors, including our financial condition, earnings, requirements under covenants in our debt instruments, legal requirements and other factors as our board of directors deems relevant. We cannot assure that our cash dividend will not be reduced, or eliminated, in the future.
Certain provisions of our corporate governing documents, Delaware law and our senior notesSenior Notes could discourage, delay, or prevent a merger or acquisition.
Provisions of our certificate of incorporation and bylaws could impede a merger, takeover or other business combination involving us or discourage a potential acquirer from making a tender offer for our common stock. For example, our certificate of incorporation authorizes our board of directors to determine the number of shares in a series, the consideration, dividend rights, liquidation preferences, terms of redemption, conversion or exchange rights and voting rights, if any, of unissued series of preferred stock, without any vote or action by our stockholders. Thus, our board of directors can authorize and issue shares of preferred stock with voting or conversion rights that could adversely affect the voting or other rights of holders of our common stock. We are also subject to Section 203 of the Delaware General Corporation Law, which imposes restrictions on mergers and other business combinations between us and any holder of 15% or more of our common stock. These provisions could have the effect of delaying or deterring a third party from acquiring us even if an acquisition might be in the best interest of our stockholders, and accordingly could reduce the market price of our common stock.
Certain provisions in the indentures governing the Senior Notes could make it more difficult or more expensive for a third party to acquire us. IfUpon an acquisition event that constitutes a “change of control,” as defined in the indentures governing the Senior Notes, coupled with a downgrade in the ratings of the Senior Notes, holders of such notes will have the right to require us to purchase their notes in cash (in the case of the 2027 Notes, the right will apply only if the change in control is coupled with a ratings downgrade).cash. Our obligations under the Senior Notes
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could increase the cost of acquiring us or otherwise discourage a third party from acquiring us or removing incumbent management, and accordingly could cause a reduction in the market price of our common stock.
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ITEM 1B. UNRESOLVED STAFF COMMENTS
Not applicable.
ITEM 2.    PROPERTIES
We own or lease approximately 90 properties consisting of manufacturing plants, engineering and research centers, distribution warehouses, offices and other facilities. We believe that the properties are maintained in good operating condition and are suitable for their intended use. In general, our facilities meet current operating requirements for the activities currently conducted within the facilities.
Our major facilities (those with 50,000 or greater square feet) at December 31, 20202022 are as follows:
LocationPrimary useSquare
Footage
Owned or
Leased
Olive Branch, MSDistribution warehouse627,000Leased
Kamunting, MalaysiaManufacturing286,000Owned
Nuevo Laredo, MexicoManufacturing277,000Leased
Asheboro, NCTecate, Mexico204,000Owned
Tecate, MexicoManufacturing172,000Owned
Morrisville, NCChihuahua, Mexico162,000Leased
Chihuahua, MexicoManufacturing153,000Owned
Maple Grove, MNManufacturing129,000Owned
Morrisville, NCOffice administration121,000Leased
Zdar Nad Sazauou, Czech RepublicManufacturing108,000Owned
Trenton, GAManufacturing102,000Owned
Chihuahua, MexicoManufacturing100,000Leased
Hradec Kralove, Czech RepublicManufacturing92,000Owned
Chelmsford, MAManufacturing91,000Leased
Kulim, MalaysiaManufacturing90,000Owned
Kernen, Germany86,000Leased
Arlington Heights, ILManufacturing86,000Leased
Wayne, PAJaffrey, NH84,000Leased
Jaffrey, NHManufacturing81,000Owned
Kamunting, MalaysiaManufacturing77,000Leased
Pleasanton, CAManufacturing76,000Leased
Chihuahua, MexicoManufacturing63,000Owned
Reading, PAEngineering and research63,000Leased
Limerick, IrelandManufacturing59,000Owned
Wayne, PAOffice administration58,000Leased
Mansfield, MAManufacturing57,000Leased
Plymouth, MAMNManufacturing55,000Leased
Bad Liebenzell, GermanyManufacturing53,000Leased
Operations in each of our business segments are conducted at locations both in and outside of the U.S. Of the facilities listed above, with the exception of Plymouth, MN, Jaffrey, NH, Mansfield, MA, Trenton, GA, and Limerick, Ireland, which are used solely for the OEM segment, our facilities generally serve more than one business segment and are often used for multiple purposes, such as administrative/sales, manufacturing and warehousing/distribution.
In addition to the properties listed above, we own or lease approximately 700,000 square feet of additional warehousing, manufacturing and office space worldwide.

ITEM 3.    LEGAL PROCEEDINGS
We are party to various lawsuits and claims arising in the normal course of business. These lawsuits and claims include actions involving product liability and product warranty, intellectual property, contracts, employment and environmental matters. As of December 31, 20202022 and 2019,2021, we accrued liabilities of $0.3$0.5 million and $0.4$0.2 million respectively, in connection with these matters, representing our best estimate of the cost within the range of
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estimated possible loss that will be incurred to resolve these matters. Based on information currently available, advice of counsel, established reserves and other resources, we do not believe that any such actions are likely to be, individually or in the aggregate, material to our business, financial condition, results of operations or cash flows. However, in the event of unexpected further developments, it is possible that the ultimate resolution of these matters, or other similar matters, if unfavorable, may be materially adverse to our business, financial condition, results of operations or cash flows. See Note 17 to the consolidated financial statements included in this Annual Report on Form 10-K for additional information.

ITEM 4.    MINE SAFETY DISCLOSURES

Not applicable.
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PART II

ITEM 5.    MARKET FOR REGISTRANT’S COMMON EQUITY, RELATED STOCKHOLDER MATTERS AND ISSUER PURCHASES OF EQUITY SECURITIES

Our common stock is listed on the New York Stock Exchange under the symbol “TFX.” As of February 23, 2021,21, 2023, we had 413367 holders of record of our common stock. A substantially greater number of holders of our common stock are beneficial owners whose shares are held by brokers and other financial institutions for the accounts of beneficial owners.
Stock Performance Graph
The following graph provides a comparison of five year cumulative total stockholder returns of Teleflex common stock, the Standard & Poor’s (S&P) 500 Stock Index and the S&P 500 Healthcare Equipment & Supply Index. The annual changes for the five-year period shown on the graph are based on the assumption that $100 had been invested in Teleflex common stock and each index on December 31, 20152017 and that all dividends were reinvested.
tfx-20201231_g3.jpg
MARKET PERFORMANCE
Company / Index201520162017201820192020
Teleflex Incorporated100124192201294322
S&P 500 Index100112136130171203
S&P 500 Healthcare Equipment & Supply Index100106139159206245
tfx-20221231_g3.jpg

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MARKET PERFORMANCE
Company / Index201720182019202020212022
Teleflex Incorporated100.00104.45152.76167.66134.31102.59
S&P 500 Index100.0095.62125.72148.85191.58156.88
S&P 500 Healthcare Equipment & Supply Index100.00114.24148.06175.90210.90166.35


ITEM 6.     SELECTED FINANCIAL DATARESERVED
2020(1)
2019(1)
2018(1)
2017(1)
2016(1)
 (Dollars in thousands, except per share)
Statement of Income Data:
Net revenues$2,537,156 $2,595,362 $2,448,383 $2,146,303 $1,868,027 
Income from continuing operations before interest, loss on extinguishment of debt and taxes$423,068 $427,254 $321,704 $372,279 $319,453 
Income from continuing operations$335,801 $461,981 $196,432 $155,263 $237,651 
Amounts attributable to common shareholders for income from continuing operations$335,801 $461,981 $196,432 $155,263 $237,187 
Per Share Data:
Income from continuing operations — basic$7.22 $10.00 $4.30 $3.45 $5.47 
Income from continuing operations — diluted$7.10 $9.81 $4.20 $3.33 $4.98 
Cash dividends$1.36 $1.36 $1.36 $1.36 $1.36 
Balance Sheet Data:
Total assets$7,152,559 $6,309,820 $6,277,991 $6,181,492 $3,891,213 
Long-term borrowings$2,377,888 $1,858,943 $2,072,200 $2,162,927 $850,252 
Shareholders’ equity$3,336,457 $2,979,320 $2,539,978 $2,430,531 $2,137,517 
Statement of Cash Flows Data:
Net cash provided by operating activities from continuing operations$437,143 $437,068 $435,086 $426,301 $410,590 
Net cash used in investing activities from continuing operations$(837,783)$(73,481)$(196,394)$(1,832,855)$(56,974)
Net cash provided by (used in) financing activities from continuing operations$455,163 $(418,836)$(206,433)$1,141,259 $(118,692)
Certain financial information is presented on a rounded basis, which may cause minor differences.
(1) Amounts include the impact of businesses acquired and disposed of during the period, commencing on the respective acquisition or disposition dates. See Note 4 to the consolidated financial statements included in this Annual Report on Form 10-K for additional information related to the acquisitions and dispositions for the years ended December 31, 2020, 2019 and 2018.Not applicable.
 

ITEM 7.     MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
Overview
We are a global provider of medical technology products focused on enhancing clinical benefits, improving
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patient and provider safety and reducing total procedural costs. We primarily design, develop, manufacture and supply medical devices used by hospitals and healthcare providers for common diagnostic and therapeutic procedures in critical care and surgical applications. Approximately 95% of our net revenues come from single-use medical devices. We market and sell our products worldwide through a combination of our direct sales force and distributors. Because our products are used in numerous markets and for a variety of procedures, we are not dependent upon any one end-market or procedure. We are focused on achieving consistent, sustainable and profitable growth by increasing our market share and improving our operating efficiencies.
We evaluate our portfolio of products and businesses on an ongoing basis to ensure alignment with our overall objectives. Based on our evaluation, we may identify opportunities to expand our margins through strategic divestitures of existing businesses and product lines that do not meet our objectives. In addition, we may seek to optimize utilization of our facilities through restructuring initiatives designed to further reduce our cost base and enhance our competitive position. Finally,In addition, we may continue to explore opportunities to expand the size of our business and improve our margins through a combination of acquisitions and distributor to direct sales conversions, which generally involve our elimination of a distributor from the sales channel, either by acquiring the distributor or terminating the distributor relationship (in some instances, particularly in Asia, the conversions involve our acquisition or termination of a master distributor and the continued sale of our products through sub-distributors). Our distributor to direct sales conversions are designed to facilitate improved product pricing and more direct access to the end users of our products within the sales channel. Further, we may identify opportunities to expand our margins through strategic divestitures of existing businesses and product lines that no longer meet our objectives.
Acquisitions
On June 13, 2022, we acquired a privately-owned catheter company for an initial cash payment of $22.8 million. Under the terms of the acquisition agreement, we may become obligated to make additional cash payments of up to $26.2 million if certain commercial and revenue goals are met. The acquisition, which complements our interventional product portfolio, principally consisted of a proprietary catheter design and other related intellectual property.
On September 27, 2022, we completed the acquisition of Standard Bariatrics, Inc., a privately-held medical device company that commercialized a powered stapling technology for bariatric surgery that complements our surgical product portfolio. The fair value of consideration transferred was $211.8 million, which included cash payments of $173.0 million and $38.8 million in estimated fair value of contingent consideration. The contingent consideration liability represents the estimated fair value of our obligations, under the acquisition agreement, to make three milestone payments up to $130 million, in aggregate, if certain commercial milestones are met. The acquisition was financed using borrowings under our revolving credit facility and cash on hand. See Note 4 to the consolidated financial statements included in this report for additional information.
Divestiture
On May 15, 2021, we entered into a definitive agreement to sell certain product lines within our global respiratory product portfolio to Medline for consideration of $286.0 million, reduced by $12 million in working capital not transferring to Medline (the "Respiratory business divestiture"). In connection with the Respiratory business divestiture, we also entered into several ancillary agreements with Medline to help facilitate the transfer of the business, which provide for transition support, quality, supply and manufacturing services, including a manufacturing and supply transition agreement (the "MSTA").
On June 28, 2021, we completed the initial phase of the Respiratory business divestiture, pursuant to which we received cash proceeds of $259 million. The second phase of the Respiratory business divestiture will occur once we transfer certain additional manufacturing assets to Medline. Our receipt of $15.0 million in additional cash proceeds is contingent upon the transfer of these manufacturing assets and is expected to occur prior to the end of 2023. We plan to recognize the contingent consideration, and any gain on sale resulting from the second phase of the divestiture, when it becomes realizable.
Economic factors impacting our business
The residual effects from the COVID-19 pandemic continue to impact global economic conditions, which have affected our financial results and global operations, as well as our contractors, suppliers, customers and other business partners. Consequently, we have experienced increased levels of overall cost inflation and challenges within our supply chain. Constraints on the supply of specific raw materials used to manufacture our products have and continue to impact delivery times and have resulted in an increased level of backorders. Moreover, pandemic related measures, as well as staffing shortages at healthcare facilities stemming from the pandemic, have and
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On February 18, 2020, we acquired IWG High Performance Conductors, Inc. (HPC), a privately-held original equipment manufacturercontinue to result in varying levels of minimally invasive medical productsreduced demand within certain of our segments and high performance conductors, for an initial cash purchase price of $260.0 million. The acquisition, which complements our OEM product portfolio, was financed using borrowings under our revolving credit facility.
On December 28, 2020, we acquired Z-Medica, LLC ("Z-Medica"), a privately held medical device company that manufactures and sells hemostatic (hemorrhage control) products, marketed under the QuikClot, Combat Gauze and QuickClot Control+ brand names. The acquisition included an initial cash purchase price of $500.0 million with the potentiallines due to make an additional payment of uplower elective procedure volumes compared to $25 million upon the achievement of certain commercial milestones. The Z-Medica acquisition, which complements our anesthesia product portfolio, was financed using borrowings under our revolving credit facility.
COVID-19 pandemic and related economic factorspre-pandemic levels.
We continue to experiencemonitor the effects of the global pandemic caused by the COVID-19 novel strain of coronavirus. Among other things, the response tomacro-economic impacts stemming from the COVID-19 pandemic, has had the effect of reducing the number of elective procedures being carried out, which has impacted and continues to impact some of our product categories, including our interventional urology, surgical, interventional, anesthesia and OEM products, which have experienced and continue to experience decreased demand. We have also experienced and continue to experience increased demand for products used in the treatment of patients with COVID-19, which are mostly concentrated in our respiratory and vascular access product categories. For the year ended December 31, 2020, each of our segments were negatively impacted by the COVID-19 pandemic due to the reduction in elective procedures and, to a lesser extent, as a result of government-mandated and self-imposed shut-downs in several countries, which were implemented to protect individuals and control the spread of COVID-19. The COVID-19 pandemic is impacting other elements of our operations, as well as ongoing geopolitical conflicts, that have contributed to material and services inflation and exchange rate volatility, as well as trade and tariff activity.
We believe that the impacts stemming from the factors discussed above will continue to affect our employees, contractors, suppliers, customers, freight transport providersbusiness, and other business partners. To date, we have not experienced significant disruptionsconsequentially our financial position, results of operations and liquidity, particularly in the global supply chain for our productsnear term, and that are in high demand, but, in some cases, delivery times have lengthened, resulting in backorders for some of our products.
In addition, there have been and continues tosuch impact would be impacts on our cost structure resulting from measures that we and other businesses are taking or will take, in accordance with governmental requirements and otherwise, to protect our employees and business partners. We continue to assess the impact on our business (including our employees, customers and suppliers) of travel restrictions, border closures and quarantines as they affect our various sites, including our 35 global manufacturing sites. In most jurisdictions, our manufacturing and distribution sites remain open because we are considered an essential business. However, we have experienced temporary or partial work stoppages in some manufacturing sites in North America and Asia. During the year ended December 31, 2020, we experienced, and we continue to experience, inefficiencies in our manufacturing operations due to government-mandated and self-imposed restrictions placed on and safety measures implemented at our facilities globally. From an operating expense perspective, we have experienced and continue to experience net decreases in selling, general and administrative expenses as a result of thesignificant if COVID-19 pandemic due to cost mitigation efforts implemented to control discretionary spending including selling, marketing and travel and entertainment related costs and lower performance related employee-benefit costs.
We have yet to return to the revenue growth levels that we achieved prior to the onset of the pandemic. In addition, the degree of improvement has varied by product category and by region. It is uncertain whether this trend will continue or if we will again experience a decrease in the number of elective procedures performed as the COVID-19 pandemic evolves, particularly if the virus becomes more prevalent as we progress through the winter season in the Northern Hemisphere or if new strains of the virus continue to emerge. Overall, we believe that the COVID-19 pandemic will continue to negatively affect our revenues and operations, at least over the near-term. Becausegeopolitical conflicts escalate. As a result of the dynamic nature of the crisis, such as recent regional COVID-19 outbreaks that are impacting the recovery,each of these factors, we cannot accurately predict the extent or duration of the impacts of the pandemic.
The COVID-19 pandemic has also had an adverse impact on macroeconomic conditions across the countries and regions in which we operate. As a result, various forms of policy interventions from local governments have been enacted to attempt to initiate an economic recovery. While there generally has been some improvement in economic conditions in the later part of 2020, the degree of improvement has been uneven among our regional markets, and the uncertain economic trends after the COVID-19 pandemic, constricted credit, public sector austerity measures in response to public budget deficits could have a material adverse effect on our results of operations and our liquidity.
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In addition to the impacts of the COVID-19 pandemic, we continue to monitor trade and tariff activity, inflation, and exchange rate volatility that could impact our financial position, results of operations or liquidity. In regards to tariff activity, we have been subject to an ongoing investigation by the Chinese authorities related to a technical error regarding our country of origin designation for certain products we imported into China. The error would have resulted in increased tariff payments in late 2018 through 2020. We have accrued the estimated increase in tariffs as well as related interest expense for the periods in question. In addition to the tariffs and related interest, the Chinese authorities may impose a penalty for the unpaid tariffs. We believe the range of penalties is between 30% and 200% of the related unpaid tariff or between $3.0 million and $20.3 million. We do not have a best estimate of the penalties that may be assessed at this time. Accordingly, as prescribed by GAAP, we have recorded $3.0 million as low end of the range described above.
Government investigation
In June 2020, we began producing documents and information in response to a Civil Investigative Demand (a “CID”) received in March 2020 by one of our subsidiaries, NeoTract, from the U.S. Department of Justice through the United States Attorney’s Office for the Northern District of Georgia (collectively, the “DOJ”). The CID relates to the DOJ’s investigation of a single NeoTract customer, requires the production of documents and information pertaining to communications with, and certain rebate programs offered to, that customer and pertains to communications and activities occurring both prior to our acquisition of NeoTract in October 2017 and thereafter. In July 2020, the DOJ advised us that it had opened an investigation under the civil False Claims Act, 31 U.S.C. §3729, with respect to NeoTract’s operations broadly in addition to the customer investigation.
We maintain policies and procedures to promote compliance with the Anti-Kickback Statute, False Claims Acts and other applicable laws and regulations and intend to provide information sought by the government. We cannot at this time reasonably predict, however, the ultimate scope or outcome of this matter, including whether an investigation may raise other compliance issues of interest, including those beyond the scope described above or how any such issues might be resolved. We also cannot at this time reasonably estimate any potential liabilities or penalty, if any, that may arise from this matter, which could have a material adverse effect on our results of operations and financial condition.business.

Results of Operations
As used in this discussion, "new products" are products for which commercial sales have commenced within the past 36 months, and “existing products” are products for which commercial sales commenced more than 36 months ago. Discussion of results of operations items that reference the effect of one or more acquired businesses (except as noted below with respect to acquired distributors) generally reflects the impact of the acquisitions within the first 12 months following the date of the acquisition. In addition to increases and decreases in the per unit selling prices of our products to our customers, our discussion of the impact of product price increases and decreases also reflects the impact on the pricing of our products resulting from any elimination of distributors, either through acquisition or termination of the distributor, from the sales channel. All dollar amounts in tables are presented in millions unless otherwise noted.
For the year ended December 31, 2020, intangible asset amortization expense of $84.4 million is included within costs of good sold. For the year ended December 31, 2019 and December 31, 2018, we reclassified intangible asset amortization expense of $82.6 million and $81.6 million, respectively, from selling, general and administrative expenses to cost of goods sold for comparability. Certain financial information is presented on a rounded basis, which may cause minor differences.
For a discussion of our results of operations comparison for 20192021 and 2018,2020, refer to our Annual Report on Form 10-K for the fiscal year ended December 31, 20192021 filed on February 21, 2020.March 1, 2022.
Comparison of 20202022 and 20192021
Revenues
202020192018
Net Revenues$2,537.2 $2,595.4 $2,448.4 
20222021
Net Revenues$2,791.0 $2,809.6 
Net revenues for the year ended December 31, 20202022 decreased by $58.2$18.6 million,or 2.2%0.7%,compared to the prior year, which was primarily attributabledue to a $108.2$124.5 million net decrease in sales volumes of existing products, largely caused by the COVID-19 pandemic, partially offset by net revenues$97.0 million of $27.1 million generated by the HPC acquisitionunfavorable fluctuations in foreign currency exchange rates and, to a lesser extent, ana net decrease in sales volumes attributed to the Respiratory business divestiture. The decreases in revenue were partially offset by a $184.9 million increase in sales of new products.products and price increases.
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Gross profit
 202020192018
Gross profit$1,324.9 $1,409.0 $1,302.8 
Percentage of revenues52.2 %54.3 %53.2 %
 20222021
Gross profit$1,531.1 $1,549.6 
Percentage of revenues54.9 %55.2 %
For the year ended December 31, 2020,2022, gross margin decreased 21030 basis points, or 3.9%0.5%, compared to the prior year period primarily due to lower sales volumescontinued cost inflation from macro-economic factors, specifically, logistics and higher manufacturingdistribution, raw materials and labor costs, both caused largelypartially offset by the COVID-19 pandemic,price increases and unfavorablefavorable fluctuations in foreign currency exchange rates.
Selling, general and administrative
 202020192018
Selling, general and administrative$743.6 $851.8 $797.1 
Percentage of revenues29.3 %32.8 %32.6 %
 20222021
Selling, general and administrative$863.7 $860.1 
Percentage of revenues30.9 %30.6 %
Selling, general and administrative expenses decreased $108.2increased $3.6 million for the year ended December 31, 2020,2022, compared to the prior year. The decreaseincrease was primarily attributable to a $92.1 million benefit from reductions in the estimated fair value of our contingent consideration liabilities, which largely related to revenue-based milestone payments, due to adverse financial projections resulting from the COVID-19 pandemic. The decrease was also attributable to lower sellinghigher sales and marketing expenses across certain of our product portfolios, higher IT related costs, including support services, and performance related employee-benefitoperating expenses incurred by acquired businesses, primarily Standard Bariatrics. The increases in selling, general and administrative costs resulting from the impacts of the COVID-19 pandemic.were partially offset by favorable fluctuations in foreign currency exchange rates.
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Research and development
 202020192018
Research and development$119.7 $113.9 $106.2 
Percentage of revenues4.7 %4.4 %4.3 %
 20222021
Research and development$153.8 $130.8 
Percentage of revenues5.5 %4.7 %
Research and development expenses increased $5.8$23.0 million for the year ended December 31, 2020,2022, compared to the prior year, which was primarily attributable to European Union Medical Device Regulation ("EU MDR") related costs partially offset by lowerand higher project spend within certain of our product portfolios.
Restructuring and impairment charges
2020 Workforce reduction2022 Restructuring plan
During the second quarter of 2020,On November 15, 2022, we committed toinitiated a workforce reduction (the "2020 Workforce reduction plan")strategic restructuring plan designed to improve profitabilityoperating performance and reduce cost primarilyposition the organization to deliver long-term durable growth by streamlining certain sales and marketing functions in our EMEA segment and certain manufacturing operations in our OEM segment. The workforce reduction was initiated to furthercreating efficiencies that align the business with our high growth strategic objectives.objectives (the “2022 restructuring plan”). The plan wasprimarily involves the relocation of certain manufacturing operations to existing lower-cost locations in addition to the streamlining of various business functions across the organization and related workforce reductions. These actions are expected to be substantially completed during 2023.
We estimate that we will incur aggregate pre-tax restructuring and restructuring related charges in connection with the 2022 restructuring plan of $39 million to $48 million. We estimate that $26 million to $32 million of these charges will result in cash outlays, most of which are expected to be made in 2023. Additionally, we expect to incur approximately $2 million in aggregate capital expenditures under the plan, most of which is expected to be incurred during 2023.
We currently expect to begin realizing plan-related savings in 2023 and expect to achieve annual pre-tax savings of $21 million to $23 million once the plan is fully implemented.
Respiratory divestiture plan
In 2021, in connection with the Respiratory business divestiture, we committed to a restructuring plan designed to separate the manufacturing operations that will be transferred to Medline from those that will remain with Teleflex, which includes related workforce reductions (the “Respiratory divestiture plan”). The plan includes expanding certain of our existing locations to accommodate the transfer of capacity from the sites that will be transferred to Medline and replicating the manufacturing processes at alternate existing locations. We expect this plan will be substantially completed by the end of 2020 and we expect future restructuring charges associated with the program, if any, to be nominal. We will achieve annual pre-tax savings of $12 million as a result of this program.
Anticipated charges and pre-tax savings related to restructuring programs and other similar cost savings initiatives2023.
We have ongoing restructuring programs primarily related to the consolidation of our manufacturing operations (referred to as our 2019, 2018 and 2014 Footprint realignment plans). We also have similar ongoing activities to relocate certain manufacturing operations within our OEM segment (the "OEM initiative")estimate that do not meet the criteria for a restructuring program under applicable accounting guidance; nevertheless, the activities should result in cost savings (we expect only minimal costs to be incurred in connection with the OEM initiative). With respect to our currently ongoing restructuring programs and the OEM initiative, the table below summarizes charges incurred or estimated to be incurred and estimated annualwe will incur aggregate pre-tax savings to be realized as follows: (1) with respect to charges (a) the estimated total charges that will have been incurred once the restructuring programs and OEM initiative are completed; (b) the charges incurred through December 31, 2020; and (c) the estimated charges to be incurred from January 1, 2021 through the last anticipated completion date of the restructuring programs and OEM initiative, and (2) with respect to estimated annual pre-tax savings (a) the estimated total annual pre-tax savings to be realized once the restructuring programs and OEM initiative are completed; (b) the estimated annual pre-tax savings realized based on the progress of the restructuring programs and OEM initiative through December 31, 2020; and (c) the estimated additional annual pre-tax savings to be realized from January 1, 2021 through the last anticipated completion date of the restructuring programs and the OEM initiative.
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Estimated charges and pre-tax savings are subject to change based on, among other things, the nature and timing of restructuring activities and similar activities, changes in the scope of restructuring programs and the OEM initiative, unanticipated expenditures and other developments, the effect of additional acquisitions or dispositions and other factors that were not reflected in the assumptions made by management in previously estimating restructuring and restructuring related charges and estimated pre-tax savings. Moreover, estimated pre-tax savings constituting efficiencies with respect to increased costs that otherwise would have resulted from business acquisitions involve, among other things, assumptions regarding the cost structure and integration of businesses that previously were not administered by our management, which are subject to a particularly high degree of risk and uncertainty. It is likely that estimates of charges and pre-tax savings will change from time to time, and the table below may reflect changes from amounts previously estimated. In addition, the table below reflects the estimated charges and pre-tax savings related to our ongoing programs in addition to our 2020 workforce reduction plan. Additional details, including estimated charges expected to be incurred in connection with our restructuring programsthe Respiratory divestiture plan of $24 million to $30 million and the anticipated completion dates, are described in Note 5 to the consolidated financial statements included in this Annual Report on Form 10-K.
Pre-tax savings may be realized during, and subsequent to, the completion of the restructuring programs. Pre-tax savings can also be affected by increases or decreases in sales volumes generated by the businesses impacted by the consolidation of manufacturing operations; such variations in revenues can increase or decrease pre-tax savings generated by the consolidation of manufacturing operations. For example, an increase in sales volumes generated by the impacted businesses, although likely to increase manufacturing costs, may generate additional savings with respect to costs that otherwise would have been incurred if the manufacturing operations were not consolidated.
Restructuring programs and other similar cost saving initiatives
Estimated TotalActual results through
December 31, 2020
Estimated Remaining
Restructuring charges$95 - $109$89$6 - $20
Restructuring charges- 2020 Workforce reduction plan99
Restructuring related charges (1)
116 - 1427442 - 68
Total charges$220 - $260$172$48 - $88
OEM initiative annual pre-tax savings (2)
$6 - $7$2$4 - $5
Pre-tax savings- 2020 Workforce reduction plan (3)
1239
Pre-tax savings- ongoing restructuring plans (4)
68 - 783236 - 46
Total annual pre-tax savings$86 - $97$37$49 - $60
(1)Represents charges that are directly related to restructuring programs and principally constitute costs to transfer manufacturing operations to existing lower-cost locations, project management costs and accelerated depreciation, as well as a charge that is expected to be imposed by a taxing authority as a result of our exit from facilities in the authority's jurisdiction. Mostsubstantially all of these charges (other than the tax charge) are expected to be recognized as cost of goods sold.
(2)We expect the OEM initiative will be completed by the end of 2027.
(3)Most of the pre-tax savings are expected to result in reductionscash outlays. Additionally, we expect to selling, general and administrative expenses.
(4)Substantially all ofincur $22 million to $28 million in aggregate capital expenditures under the pre-tax savings are expected to result in reductions to cost of goods sold.
The following discussion provides additional details with respect to our ongoing significant restructuring programs:plan.
2019 Footprint realignment plan
In February 2019, we initiated a restructuring plan primarily involving the relocation of certain manufacturing operations to existing lower-cost locations and related workforce reductions (the “2019 Footprint realignment plan"). These actions are expectedThe plan is substantially complete and as a result, we expect future restructuring expenses associated with the plan, if any, to be substantially completed by the end of 2022.
In 2020, we refined the estimated ranges for the restructuring and restructuring related charges in consideration of the progress made to date as well as the actions remaining. The refinements resulted in a decrease to the high end of our estimated ranges compared to our prior estimates and we now estimate that we will incur charges totaling $56 million to $63 million under the plan, of which we estimate that $50 million to $57 million of these charges will result in future cash outlays. We also expect a decrease in the total capital expenditures compared to
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prior estimates and we now expect to incur $28 million to $33 million in total capital expenditures under the plan, most of which we expect to be incurred by the end of 2021.
In 2020, we identified additional cost reduction measures and accelerated certain components of the plan that led to an increase in our estimated annual plan related savings as well as the recognition of savings related to the plan during the year. We now expect to achieve annual pre-tax savings of $15 million to $17 million once the plan is fully implemented.immaterial.
2018 Footprint realignment plan
In May 2018, we initiated a restructuring plan involving the relocation of certain European manufacturing operations to existing lower-cost locations, the outsourcing of certain European distribution operations and related workforce reductions. Duringreductions (the "2018 Footprint realignment plan"). The plan is substantially complete and as a result, we expect future restructuring expenses associated with the second quarter 2020 we took advantage of an opportunity to accelerate certain components of this plan, and we now expectif any, to be substantially completed by the end of 2022.
We estimate that we will incur total charges in connection with the 2018 Footprint realignment plan of $103 million to $133 million, of which, we estimate that $99 million to $127 million of these charges will result in future cash outlays. Additionally, we expect to incur $19 million to $23 million in total capital expenditures under the plan.
We began realizing plan-related savings in 2018 and expect to achieve annual pre-tax savings of $25 million to $30 million once the plan is fully implemented.immaterial.
2014 Footprint realignment plan
In April 2014, we initiated a restructuring plan (the "2014 Footprint realignment plan") involving the consolidation of operations and a related reduction in workforce at certain facilities, and the relocation of manufacturing operations from certain higher-cost locations to
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existing lower-cost locations.
During 2020, we extended our timeline of certain development and qualification activities which resulted in a one year delay in the anticipated period of substantial completion, so we now expect thelocations (the "2014 Footprint realignment plan"). The plan will beis substantially completed by the end of 2022. The shift in timing, along with other changes to the plan, also resulted in an increase in the estimated total charges, primarily restructuring related charges, and related cash outlays in addition to a decrease in the estimated total capital expenditures compared to prior estimates. We adjusted the corresponding ranges in consideration of these changes in estimates and we now estimate that we will incur total charges of $52 million to $55 million, which we expect will result in cash outlays of $42 million to $46 million, and total capital expenditures of $26 million to $27 million under the plan.
In 2020, we also identified additional cost reduction measures as the plan progressedcomplete and as a result, we increased our estimate of annual plan-related savings. We now estimate that we will achieve annual pre-tax savings of $28 million to $31 million onceexpect future restructuring expenses associated with the plan, is fully implemented.if any, to be immaterial.
The following table provides information regarding restructuring charges we have incurred with respect to each of our restructuring programs, as well as impairment charges, for the years ended December 31, 2020, 2019,2022, 2021, and 2018.2020. The restructuring charges listed in the table primarily consist of termination benefits.
202020192018 20222021
2020 Workforce reduction plan$8.8 $— $— 
2022 Restructuring plan2022 Restructuring plan$15.5 $— 
Respiratory divestiture planRespiratory divestiture plan0.6 2.7 
2021 Restructuring plan2021 Restructuring plan— 7.4 
2019 Footprint realignment plan2019 Footprint realignment plan1.5 13.8 — 2019 Footprint realignment plan(1.0)0.3 
2018 Footprint realignment plan2018 Footprint realignment plan6.0 (0.9)55.0 2018 Footprint realignment plan2.1 2.5 
2014 Footprint realignment plan0.6 0.3 0.8 
Other restructuring programsOther restructuring programs0.2 2.0 4.3 Other restructuring programs1.6 2.1 
Impairment charges (1)
Impairment charges (1)
21.4 7.0 19.1 
Impairment charges (1)
1.5 6.7 
TotalTotal$38.5 $22.2 $79.2 Total$20.3 $21.7 
(1)ImpairmentFor the year ended December 31, 2022, we recorded impairment charges recognized in 2020of $1.5 million related primarilyto our decision to abandon certain assets. For the year ended December 31, 2021, we recorded impairment charges of $6.7 million related to our decision to abandon intellectual property and other assets related to the Percuvance percutaneous surgical system product line. Impairment charges recognized in 2019 and 2018 related to our decision to abandon certain intellectual property and other assetsprimarily associated with productsour respiratory product portfolio that were eliminated from our interventional product portfolio.was not transferred to Medline as part of the Respiratory business divestiture.
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Interest expense
20202019201820222021
Interest expenseInterest expense$66.5 $80.3 $103.0 Interest expense$54.3 $57.0 
Average interest rate on debt during the yearAverage interest rate on debt during the year2.51 %3.47 %4.25 %Average interest rate on debt during the year2.8 %2.2 %
The decrease in interest expense for the year ended December 31, 20202022 compared to the prior year was primarily due to a lowerdecrease in average debt outstanding, partially offset by a higher average interest rate resulting from decreasesincreases in interest rates associated with our variable interest rate debt instruments partially offset by increases in average debt outstanding.instruments.
Gain on sale of assets and business
 20222021
Gain on sale of assets and business$6.5 $91.2 
During the year ended December 31, 2022, we recognized a gain related to a sale of a building. During the year ended December 31, 2021, we recognized a gain related to the Respiratory business divestiture.
Loss on extinguishment of debt
20222021
Loss on extinguishment of debt$0.5 $13.0 
202020192018
Loss on extinguishment of debt$— $8.8 $— 
On November 15, 2019,During the year ended December 31, 2022 we recognized a $0.5 million loss on extinguishment of debt due to the write off of unamortized deferring financing costs related to the amendment of our senior credit facility. During the year ended December 31, 2021, we prepaid the $250$400 million aggregate outstanding principal amount under our 2024 Notes.4.875% Senior Notes due 2026 (the "2026 Notes"). In addition to ourthe prepayment of principal, we paid to the holders of the 20242026 Notes a $6.5$9.8 million prepayment make-whole amount plus accrued and unpaid interest. We recorded the prepayment make-whole amount and a $2.3$3.2 million write-off of unamortized debt issuance costs as a loss on extinguishment of debt.
Gain on sale of assets
 202020192018
Gain on sale of assets$— $6.1 $1.4 
During the year ended December 31, 2019, we recognized a gain related to the sale of two buildings and our vein catheter reprocessing business.
Taxes on income from continuing operations
 202020192018
Effective income tax rate6.1 %(35.9)%10.6 %
We generate substantial earnings from our non-U.S. operations. A number of the non-U.S. jurisdictions in which we file tax returns historically have had tax rates that are lower than the U.S. statutory tax rate; as a result, our consolidated effective income tax rate for 2020 and earlier years has been substantially below the U.S. statutory tax rate. The principal non-U.S. jurisdictions in which the tax rate in 2020 and earlier years was lower than the U.S. statutory tax rate and from which we derive substantial earnings included Ireland, Bermuda, and Singapore.
 20222021
Effective income tax rate18.6 %13.3 %
The effective income tax rate for 2020 was 6.1% compared2022 reflects tax expense resulting from a deferred charge relating to (35.9)% for 2019. Taxes on incomethe 2022 Restructuring Plan and tax expense resulting from continuing operationsa U.S. law effective in 2020 reflects non-taxable contingent consideration adjustments, recognized in connection with a decrease in the fair value2022 requiring capitalization of our contingent consideration liabilities.certain research and development expenditures. The effective income tax rate for 20192021 reflects a tax benefit of $129 million resulting from a non-U.S. legal entity restructuring that eliminatedexpense associated with the requirement to provide for withholding taxes on the future repatriation of certain non-permanently reinvested earnings.Respiratory business divestiture. Additionally, the effective tax rates for both 20202022 and 20192021 reflect a net
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excess tax benefit related to share-based compensation and a tax benefit relatingfrom research and development tax credits.
On August 16, 2022, the Inflation Reduction Act of 2022 was signed into law, which, among other things, implemented a 15% minimum tax on book income of certain large corporations. We continue to evaluate the revaluationimpact the law will have on consolidated results of state deferred tax assets and liabilities dueoperations, but it is not expected to business integrations and other changes. See Note 15 to thehave a material effect on our consolidated financial statements includedstatements.
In December 2022, the EU adopted a directive that requires each EU Member State to enact national legislation establishing a 15% global minimum tax that is required to become effective in 2024. Although specific provisions of the proposed future laws of the individual Member States are not fully known at this Annual Report on Form 10-K for additional information.time, we anticipate that potential enactments of these laws by the Member States could impact our tax obligations in future periods.

Segment Results
Segment Net Revenues
 Year Ended December 31% Increase/(Decrease)
 2020201920182020 vs 20192019 vs 2018
Americas$1,465.0 $1,492.3 $1,351.7 (1.8)10.4 
EMEA584.9 588.1 603.8 (0.5)(2.6)
Asia267.0 294.3 286.9 (9.3)2.6 
OEM220.3 220.7 206.0 (0.2)7.2 
Segment Net Revenues$2,537.2 $2,595.4 $2,448.4 (2.2)6.0 
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 Year Ended December 31% Increase/(Decrease)
 202220212022 vs 2021
Americas$1,653.7 $1,659.3 (0.3)
EMEA558.4 606.8 (8.0)
Asia306.3 297.8 2.9 
OEM272.6 245.7 11.0 
Segment Net Revenues$2,791.0 $2,809.6 (0.7)
Segment Operating Profit
Year Ended December 31,% Increase/(Decrease) Year Ended December 31,% Increase/(Decrease)
2020201920182020 vs 20192019 vs 2018 202220212022 vs 2021
AmericasAmericas$401.4 $319.9 $255.8 25.5 25.1 Americas$452.0 $424.2 6.6 
EMEAEMEA81.3 94.4 106.1 (13.8)(11.0)EMEA42.5 94.9 (55.2)
AsiaAsia51.2 73.1 78.1 (29.9)(6.5)Asia82.8 84.6 (2.2)
OEMOEM44.9 58.0 50.3 (22.7)15.3 OEM65.4 56.2 16.3 
Segment Operating Profit (1)
Segment Operating Profit (1)
$578.8 $545.4 $490.3 6.1 11.2 
Segment Operating Profit (1)
$642.7 $659.9 (2.6)
(1)See Note 18 to the consolidated financial statements included in this Annual Report on Form 10-K for a reconciliation of segment operating profit to our consolidated income from continuing operations before interest, loss on extinguishment of debt and taxes.
Americas
Americas net revenues for the year ended December 31, 20202022 decreased $27.3$5.6 million, or 1.8%0.3%, compared to the prior year, which was primarily attributable to a $33.7$192.9 million decrease in sales volume of existing products and, to a lesser extent, a net decrease in sales volumes of existing products, largely caused byattributed to the COVID-19 pandemic,Respiratory business divestiture. The decreases in revenue were partially offset by a $7.7$175.1 million increase in sales of new products.products and price increases.
Americas operating profit for the year ended December 31, 20202022 increased $81.5$27.8 million, or 25.5%6.6%, compared to the prior year, which was primarily attributable to lower performance related employee-benefit expenses, a decrease in contingent consideration expense and lower general and administrative expenses. The increases in operating profit were partially offset by higher sales and marketing expenses across certain of our product portfolios.
EMEA
EMEA net revenues for the year ended December 31, 2022 decreased $48.4 million, or 8.0%, compared to the prior year, which was primarily attributable to $63.9 million of unfavorable fluctuations in foreign currency exchange rates, partially offset by an increase in sales volumes of existing products.
EMEA operating profit for the year ended December 31, 2022 decreased $52.4 million, or 55.2%, compared to the prior year, which was primarily attributable to unfavorable fluctuations in foreign currency exchange rates and an increase in EU MDR costs within research and development.
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In 2015, the Italian parliament enacted legislation that, among other things, imposed a “payback” measure on medical device companies that supply goods and services to the Italian National Healthcare System. Under the measure, companies are required to make payments to the Italian government if medical device expenditures in a given year exceed regional expenditure ceilings established for that year. The payment amounts are calculated based on the amount by which the regional ceilings for the given year were exceeded. Considerable uncertainty exists related to the enforceability of and implementation process for the payback law. In response to decrees issued by the Italian Ministry of Health, the various Italian regions issued invoices to medical device companies, including Teleflex, under the payback measure in the fourth quarter of 2022 seeking payment with respect to excess expenditures for the years 2015 through 2018. Following the issuance of the invoices, we and numerous other medical device companies filed appeals with the Italian administrative courts challenging the enforceability of the payback measure, which appeals remain pending. As of December 31, 2022, our reserve for this matter is $10.9 million, $2.6 million of which was recorded as a reduction of revenue for 2022. If the payback was to ultimately be enforced in its existing form, we estimate that we would be required to remit payments in excess of our current reserve of up to $23 million.
Asia
Asia net revenues for the year ended December 31, 2022 increased $8.5 million, or 2.9%, compared to the prior year, which was primarily attributable to a benefit from a reduction in the estimated fair value of our contingent consideration liabilities, which largely relate to revenue-based milestone payments, due to adverse financial projections resulting from the COVID-19 pandemic. The$30.1 million increase in operating profit wassales volumes of existing products, partially offset by a decrease$23.7 million of unfavorable fluctuations in grossforeign currency exchange rates.
Asia operating profit resulting from lower sales caused by the COVID-19 pandemic.
EMEA
EMEA net revenues for the year ended December 31, 20202022 decreased $3.2$1.8 million, or 0.5%2.2%, compared to the prior year, which was primarily attributable to a $10.3 million net decrease in sales volumes of existing products caused by the COVID-19 pandemic, partially offset by favorable fluctuations in foreign currency exchange rates of $6.3 million.
EMEA operating profit for the year ended December 31, 2020 decreased $13.1 million, or 13.8%, compared to the prior year, which was primarily attributable to a decrease in gross profit resulting from lower sales and higher manufacturing costs, both caused by the COVID-19 pandemic, and an increase in research and development expenses. The decreases in operating profit were partially offset by lower selling, general and administrative expenses.
Asia
Asia net revenues for the year ended December 31, 2020 decreased $27.3 million, or 9.3%, compared to the prior year. The decrease was primarily attributable to a $36.3 million net decrease in sales volumes of existing products, caused by the COVID-19 pandemic, partially offset by an increase in sales of new products.
Asia operating profit for the year ended December 31, 2020 decreased $21.9 million, or 29.9%, compared to the prior year, which was primarily attributable to a decrease in gross profit resulting from lower sales caused by the COVID-19 pandemic and unfavorable fluctuations in foreign currency exchange rates and a benefit recognized in the prior year resulting from the reversal of a contingent liability related to tariffs imposed by Chinese authorities, which is described in Note 17 to the consolidated financial statements included in this Annual Report on Form 10-K, partially offset by lower selling, general and administrative expenses.an increase in gross profit resulting from higher sales.
OEM
OEM net revenues for the year ended December 31, 2020 decreased $0.42022 increased $26.9 million, or 0.2%11.0% compared to the prior year which was primarily attributable to a $27.8$21.7 million net decreaseincrease in sales volumes of existing products caused by the COVID-19 pandemic largelyand price increases, partially offset by net revenues of $27.1 million generated by the HPC acquisition.unfavorable fluctuations in foreign currency exchange rates.
OEM operating profit for the year ended December 31, 2020 decreased $13.12022 increased $9.2 million, or 22.7%16.3%, compared to the prior year, which was primarily attributable to a decreasean increase in gross profit resulting from lowerhigher sales caused by the COVID-19 pandemic and higher manufacturing costs,volume, partially offset by gross profit generated by the HPC acquisition.an increase in general and administrative expenses.

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Liquidity and Capital Resources
We assess our liquidity in terms of our ability to generate cash to fund our operating, investing and financing activities. Our principal source of liquidity is our cash flows provided by operating activities. Our cash flows provided by operating activities are reduced by cash used to, among other things, fulfill contractual obligations for minimum lease payments under noncancellable operating leases, which often extend beyond one year; the weighted average remaining lease term of our operating lease portfolio is 6.7 years7.9 years. Our cash flows provided by operating activities are also reduced by cash used for unconditional legally binding commitments to purchase goods or services (i.e., purchase obligations), which are primarily related to inventory expected to be purchased within one year. Our net cash provided by operating activities was significantly in excess of amounts paid pursuant to these contractual obligations for the years ended December 31, 2020, 2019 and 2018.
In addition to operating cash flows, otherOther significant factors that affect our overall management of liquidity include contractual obligations such as scheduled principal and interest payments with respect to outstanding indebtedness and tax on deemed repatriation of non-U.S. earnings, which will be paid annually over the next 5 years, and annual pension funding.three years. We may also be obligated to make payments for contingent consideration due to past acquisitions, the timing and amount of which may be uncertain, and the magnitude of which can vary from year to year. Other significant factors that affect our liquidity include certain actions controlled by management such as capital expenditures, acquisitions, dividends and incremental pension and post-retirement benefit payments.dividends. See Note 10, Note 12 and Note 15 and Note 16 to the consolidated financial statements included in this Annual Report on Form 10-K for additional information.
Our contractual obligations at December 31, 2020 were as follows:
Payments due by period
TotalLess than
1 year
1-3
years
3-5
years
More than
5 years
Total borrowings$2,498.0 $100.5 $78.8 $918.7 $1,400.0 
Interest obligations (1)
483.0 83.3 164.0 132.3 103.4 
Operating lease obligations126.0 26.2 41.8 21.9 36.1 
Minimum purchase obligations (2)
233.8 220.0 12.6 1.2 — 
Tax on deemed repatriation of foreign earnings (3)
116.7 12.3 35.3 69.1 — 
Other postretirement benefits36,812.0 4,844.3 8,985.4 7,562.2 15,420.1 
Total contractual obligations$40,269.5 $5,286.6 $9,317.9 $8,705.4 $16,959.6 
(1)Interest payments on floating rate debt are based on the interest rate in effect on December 31, 2020.
(2)Purchase and other obligations are defined as unconditional commitments to purchase goods or services that are legally binding and that specify all significant terms, including: quantities to be purchased; price provisions; and the approximate timing of the transaction. The amounts include commitments for inventory purchases and capital expenditures (which, at the time we entered into the commitments, did not exceed our projected requirements in the normal course of business) and penalties due upon cancellation of cancellable agreements; the amounts exclude operating lease obligations, which are addressed elsewhere in the table.
(3)As permitted by the TCJA, we have elected to pay the tax in annual installments over eight years.
We believe our cash flow from operations, available cash and cash equivalents and borrowings under our revolving credit facility (which is provided for under the Credit Agreement) and accounts receivable securitization facility will enable us to fund our operating requirements, capital expenditures and debt obligations for the next 12 months and the foreseeable future.
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Of our $375.9$292.0 million of cash and cash equivalents at December 31, 2020, $310.42022, $256.9 million was held at non-U.S. subsidiaries. We manage our worldwide cash requirements by monitoring the funds available among our subsidiaries and determining the extent to which we can access those funds on a cost effective basis.
We have entered into cross-currency swap agreements with different financial institution counterparties to hedge against the effect of variability in the U.S. dollar to euro exchange rate. Under the terms of the cross-currency swap agreements, we notionally exchanged in the aggregate $750 million for €653.1 million. The swap agreements, which begin to expire in October 2023, are designated as net investment hedges and require an exchange of the notional amounts upon expiration or the earlier termination of the agreements. We and the counterparties have agreed to effect the exchange through a net settlement. As a result, we may be required to pay (or be entitled to receive) an amount equal to the difference, on the expiration or earlier termination dates, between the U.S. dollar
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equivalent of the €653.1 million notional amount and the $750 million notional amount. If, at the expiration or earlier termination of the swap agreements, the U.S. dollar to euro exchange rate has increased or declined by 10% from the rate in effect at the inception of these agreements, we would receive from or be required to pay to the counterparties an aggregate of approximately $75.0 million in respect of the notional settlement. As of December 31, 2020,2022, we had $20.1$48.5 million in current assets and $34.1$11.9 million in long term liabilitiesnon-current assets related to the fair value of our cross-currency swap agreements. The swap agreements entail risk that the counterparties will not fulfill their obligations under the agreements. However, we believe the risk is reduced because we have entered into separate agreements with different counterparties, all of which are large, well-established financial institutions.
We may at any time, from time to time, repurchase our outstanding debt securities in open market purchases, via tender offers or in privately negotiated transactions, exchange transactions or otherwise, at such price or prices as we deem appropriate. Such purchases or exchanges, if any, will depend on prevailing market conditions, our liquidity requirements, contractual restrictions and other factors and may be commenced or suspended at any time.
Summarized Financial Information – Obligor Group
The 2026 Notes and 2027 Notes (collectively, the "Senior Notes") are issued by Teleflex Incorporated (the “Parent Company”), and payment of the Parent Company's obligations under the Senior2027 Notes is guaranteed, jointly and severally, by an enumerated group of the Parent Company’s subsidiaries (each, a “Guarantor Subsidiary” and collectively, the “Guarantor Subsidiaries”). The guarantees are full and unconditional, subject to certain customary release provisions. Each Guarantor Subsidiary is directly or indirectly 100% owned by the Parent Company. Summarized financial information for the Parent and Guarantor Subsidiaries (collectively, the “Obligor Group”) as of and for the year ended December 31, 20202022 as follows:
Year Ended December 31, 2020Year Ended December 31, 2022
Obligor GroupIntercompanyObligor Group (excluding intercompany)Obligor GroupIntercompanyObligor Group (excluding intercompany)
Net revenueNet revenue$1,734.7 $167.7 $1,567.0 Net revenue$1,983.0 $196.5 $1,786.5 
Cost of goods soldCost of goods sold935.4 366.5 568.9 Cost of goods sold1,208.6 323.3 885.3 
Gross profitGross profit799.3 (198.8)998.1 Gross profit774.4 (126.8)901.2 
Income from continuing operationsIncome from continuing operations270.7 (80.5)351.2 Income from continuing operations292.7 125.4 167.3 
Net incomeNet income270.2 (80.5)350.7 Net income292.4 125.4 167.0 

December 31, 2020December 31, 2022
Obligor GroupIntercompanyObligor Group (excluding intercompany)Obligor GroupIntercompanyObligor Group (excluding intercompany)
Total current assetsTotal current assets$785.5 $49.1 $736.4 Total current assets$878.3 $110.5 $767.8 
Total assetsTotal assets5,321.1 1,491.4 3,829.7 Total assets3,420.3 1,510.9 1,909.4 
Total current liabilitiesTotal current liabilities792.0 542.3 249.7 Total current liabilities882.9 627.9 255.0 
Total liabilitiesTotal liabilities4,166.3 850.5 3,315.8 Total liabilities3,168.0 712.3 2,455.7 
The same accounting policies as described in Note 1 to the consolidated financial statements included in our Annual Report on Form 10-K for the year ended December 31, 20202022 are used by the Parent Company and each of its subsidiaries in connection with the summarized financial information presented above. The Intercompany column in the table above represents transactions between and among the Obligor Group and non-guarantor subsidiaries (i.e., those subsidiaries of the Parent Company that have not guaranteed payment of the Senior2027 Notes). Obligor
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investments in non-guarantor subsidiaries and any related activity are excluded from the financial information presented above. The summarized financial information presented above for the Obligor Group as of and for the year ended December 31, 2020 gives effect to the 2028 Notes issued in a private offering in May 2020.
See "Financing Arrangements" below as well as Note 10 and Note 11 to the consolidated financial statements included in this Annual Report on Form 10-K for further information related to our borrowings and financial instruments.

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Cash Flows
The following table provides a summary of our cash flows for the periods presented:
Year Ended December 31,
202020192018
Cash flows from continuing operations provided by (used in):
Operating activities$437.1 $437.1 $435.1 
Investing activities(837.8)(73.5)(196.4)
Financing activities455.2 (418.8)(206.4)
Cash flows (used in) provided by discontinued operations(0.7)2.5 2.3 
Effect of exchange rate changes on cash and cash equivalents21.0 (3.4)(11.0)
Increase (decrease) in cash and cash equivalents$74.8 $(56.1)$23.6 
Year Ended December 31,
20222021
Cash flows from continuing operations provided by (used in):
Operating activities$342.8 $652.1 
Investing activities(259.4)156.7 
Financing activities(217.5)(715.8)
Cash flows provided by (used in) discontinued operations0.8 (0.7)
Effect of exchange rate changes on cash and cash equivalents(19.8)(23.1)
(Decrease) increase in cash and cash equivalents$(153.1)$69.2 
Cash Flow from Operating Activities
Net cash provided by operating activities from continuing operations was $437.1$342.8 million during 20202022, and 2019. In 2020, the cash flows from operations reflect$652.1 million during 2021. The $309.3 million decrease was primarily attributable to less favorable operating results and unfavorable changes in working capital. The unfavorable change in working capital was primarily attributable to a decrease in income taxes due to higher tax payments, a decrease in accounts payable and accrued expenses, primarily due to higher payroll and benefit related payments, and an increase in contingent consideration payments and tax payments that were partially offset by favorable changes in other working capital. The favorable changes in working capital were driven mainly by higher accounts receivable collections.inventories due to purchases to maintain customer service levels during a period of elevated global supply chain volatility.
Cash Flow from Investing Activities
Net cash used in investing activities from continuing operations was $837.8$259.4 million during 2020, which included $767.82022, primarily consisted of $198.4 million in net payments for businesses and intangibles acquired businesses, primarily Z-Medica and HPC,$79.2 million of capital expenditures of $90.7 million and net interest proceeds on swaps designated as net investment hedges of $19.3 million.expenditures.
Cash Flow from Financing Activities
Net cash provided byused in financing activities from continuing operations was $455.2$217.5 million during 2020,2022, which reflectedprimarily consisted of a net increasereduction in borrowings of $575.0$140.3 million primarily resulting from the issuance of $500 million of 4.25% Senior Notes due 2028 (the "2028 Notes") and additional borrowings totaling $75.0 million underpayments made against our revolvingsenior credit facility and securitization program. Net cash provided by financing activities for the year ended December 31, 2020 also reflects contingent consideration payments of $67.2$63.8 million andin dividend payments of $63.2 million.payments.
For a discussion of our cash flow comparison for 20192021 and 2018,2020, refer to our Annual Report on Form 10-K for the fiscal year ended December 31, 2019.2021 filed on March 1, 2022.
Free Cash Flow
Free cash flow is a non-GAAP financial measure and is calculated by subtracting capital expenditures from cash provided by operating activities from continuing operations. This financial measure is used in addition to and in conjunction with results presented in accordance with generally accepted accounting principles in the U.S., or GAAP, and should not be considered a substitute for net cash provided by operating activities from continuing operations, the most comparable GAAP financial measure. Management believes that free cash flow is a useful measure to investors because it facilitates an assessment of funds available to satisfy current and future obligations, pay dividends and fund acquisitions. We also use this financial measure for internal managerial purposes and to evaluate period-to-period comparisons. Free cash flow is not a measure of cash available for discretionary expenditures since we have certain non-discretionary obligations, such as debt service, that are not deducted from the measure. We strongly encourage investors to review our financial statements and publicly-filed reports in their entirety and not to rely on any single financial measure. The following is a reconciliation of free cash flow to the most comparable GAAP measure.
 202020192018
Net cash provided by operating activities from continuing operations$437.1 $437.1 $435.1 
Less: Capital expenditures90.7 102.7 80.8 
Free cash flow$346.4 $334.4 $354.3 
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 20222021
Net cash provided by operating activities from continuing operations$342.8 $652.1 
Less: Capital expenditures79.2 71.6 
Free cash flow$263.6 $580.5 

Financing Arrangements
 
The following table provides our net debt to total capital ratio:
2020201920222021
Net debt includes:Net debt includes:Net debt includes:
Current borrowingsCurrent borrowings$100.5 $50.0 Current borrowings$87.5 $110.0 
Long-term borrowingsLong-term borrowings2,377.9 1,858.9 Long-term borrowings1,624.0 1,740.1 
Unamortized debt issuance costsUnamortized debt issuance costs19.6 14.1 Unamortized debt issuance costs11.8 13.4 
Total debtTotal debt2,498.0 1,923.0 Total debt1,723.3 1,863.5 
Less: Cash and cash equivalentsLess: Cash and cash equivalents375.9 301.1 Less: Cash and cash equivalents292.0 445.1 
Net debtNet debt2,122.1 1,621.9 Net debt1,431.3 1,418.4 
Total capital includes:Total capital includes:  Total capital includes:  
Net debtNet debt2,122.1 1,621.9 Net debt1,431.3 1,418.4 
Shareholders’ equityShareholders’ equity3,336.5 2,979.3 Shareholders’ equity4,022.0 3,754.7 
Total capitalTotal capital$5,458.6 $4,601.2 Total capital$5,453.3 $5,173.1 
Percent of net debt to total capitalPercent of net debt to total capital38.9 %35.2 %Percent of net debt to total capital26.2 %27.4 %
Fixed rate debt comprised 56.0%58.0% and 46.8%53.7% of total debt at December 31, 20202022 and 2019,2021, respectively. The increase in fixed rate borrowings as a percentage of total borrowings as of December 31, 20202022 compared to the prior year was driven by the issuance of the 2028 Notes.due to payments made on our senior credit facility.
Senior credit facility
On April 5, 2019,November 4, 2022, we entered into a second amended and restated our existing credit agreement by entering into a Third Amended and Restated Credit Agreement (the "Credit Agreement"“Credit Agreement”), which provides for a five-year revolving credit facility of $1.0 billion and a term loan facility of $500.0 million. The obligations under the Credit Agreement are guaranteed (subject to certain exceptions and limitations) by substantially all of our material domestic subsidiaries. The obligations under the Credit Agreement are secured, subject to certain exceptions and limitations, by a lien on substantially all of the assets owned by us and each guarantor. The maturity date of the revolving credit facility and a $700 million term loan facility, each of which matures on April 5, 2024. The Credit Agreement replaces a previous credit agreement under which we were provided a $1.0 billion credit facility and a $750 million term loan facility, due 2022 (the “prior term loan”). The $700 millionthe term loan facility under the Credit Agreement principally was applied against the remaining $675 million principal balance of the prior term loan.is November 4, 2027.
At our option, loans under the Credit Agreement will bear interest at a rate equal to adjusted LIBORTerm SOFR plus an applicable margin ranging from 1.25%1.125% to 2.00% or at an alternate base rate, which is defined as the highest of (i) the “Prime Rate” in the U.S. last quoted by The Wall Street Journal, (ii) 0.50% above the greater of the federal funds rate and the rate comprised of both overnight federal funds and overnight eurodollar borrowingstransactions denominated in Dollars and (iii) 1.00% above adjusted LIBORthe Term SOFR Rate for a one month interest period, plus in each case an applicable margin ranging from 0.125% to 1.00%, in each case subject to adjustments based on our consolidated total net leverage ratio (generally, Consolidated Total Funded Indebtedness (which is net of “Qualified Cash”), as defined in the Credit Agreement, on the date of determination to Consolidated EBITDA, as defined in the Credit Agreement, for the four most recent fiscal quarters ending on or preceding the date of determination).ratio. Overdue loans will bear interest at the rate otherwise applicable to such loans plus 2.00%.
At December 31, 2020,2022, we had $350.0$148.3 million in borrowings outstanding and $1.9$0.9 million in outstanding standby letters of credit under our $1.0 billion revolving credit facility.
The Credit Agreement contains customary representations and warranties and covenants that, among other things andin each case, subject to certain exceptions, qualifications and thresholds, (a) place limitations on us and our ability,subsidiaries regarding the incurrence of additional indebtedness, additional liens, fundamental changes, dispositions of property, investments and the abilityacquisitions, dividends and other restricted payments, transactions with affiliates, restrictive agreements, changes in lines of business and swap agreements, and (b) require us and our subsidiaries to incur additional indebtedness; create additional liens; enter into a merger, consolidation or amalgamation orcomply with sanction laws and other defined "fundamental changes," disposelaws and agreements, to deliver financial information and certain other information and give notice of certain assets, make certain investments or acquisitions,events, to maintain their existence and good standing, to pay dividends, or maketheir other restricted payments, enter into swap agreements or enter into transactions with our affiliates. Additionally,obligations, to permit the administrative agent and the lenders to inspect their books and property, to use the proceeds of the Credit Agreement contains financial covenants that, subjectonly for certain permitted purposes and to specifiedprovide collateral in the future. Subject to certain exceptions, require us
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we are required to maintain a consolidatedmaximum total net leverage ratio of not more than 4.50 to 1.00 and1.00. We are further required to maintain a consolidatedminimum interest coverage ratio (generally, Consolidated EBITDA for the four most recent fiscal quarters ending on or preceding the date of determination to Consolidated Interest Expense, as defined in the Credit Agreement, paid in cash for such period) of not less than 3.50 to 1.00. As of December 31, 2020,2022, we were in compliance with the covenants in the Credit Agreement.
See Note 10 to the consolidated financial statements included in this Annual Report on Form 10-K for additional information regarding the Credit Agreement.
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2026, 2027 and 2028 Senior Notes
As of December 31, 2020,2022, the outstanding principal amount of our 2026 Notes, 2027 Notes and 2028 Notes (collectively the "Senior Notes") was $400 million, $500 million and $500 million, respectively. The indenture governing the 2026Senior Notes containcontains covenants that, among other things and subject to certain exceptions, limit or restrict our ability, and the ability of our subsidiaries, to incur additional debt or issue preferred stock or other disqualified stock, create liens, merge, consolidate, or dispose of certain assets pay dividends, make investments or make other restricted payments, or enter into transactions with our affiliates. The indenture governing the 2027 Notes contains covenants that, among other things and subject to certain exceptions, limit or restrict our ability, and the ability of our subsidiaries, to create liens; consolidate, merge or dispose of certain assets; and enter into sale leaseback transactions. The 2028 Notes contain covenants that, among other things, will restrict our ability and the ability of our subsidiaries to create certain liens, enter into sale lease back transactions, and merge, consolidate, sell or otherwise dispose of all or substantially all of our assets.The obligations under the Senior Notes are fully and unconditionally guaranteed, jointly and severally, by each of our existing and future 100% owned domestic subsidiaries that are a guarantor or other obligor under the Credit Agreement and by certain of our other 100% owned domestic subsidiaries. As of December 31, 2020,2022, we were in compliance with all of the terms of our Senior Notes.
Accounts receivable securitization
We have an accounts receivable securitization facility under which we sell an undivided interest in domestic accounts receivable for consideration of up to $75 million to a maximum amount of commercial paper conduit. In March 2020, we amended our accounts receivable securitization facility to increase the maximum available capacity from $50 million to $75 million. As of December 31, 2020,2022 and 20192021, we borrowed the maximum amount available at the time of $75.0$75 million and $50 million, respectively, under this facility. This facility is utilized to provide increased flexibility in funding short term working capital requirements. The agreement governing the accounts receivable securitization facility contains certain covenants and termination events. An occurrence of an event of default or a termination event under this facility may give rise to the right of our counterparty to terminate this facility. As of December 31, 2020,2022, we were in compliance with the covenants and none of the termination events had occurred.
For additional information regarding our indebtedness, see Note 10 to the consolidated financial statements included in this Annual Report on Form 10-K.

Critical Accounting Policies and Estimates
 
The preparation of consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ materially from the amounts derived from those estimates and assumptions. 
We have identified the following as critical accounting estimates, which are defined as those that are reflective of significant judgments and uncertainties, are the most pervasive and important to the presentation of our financial condition and results of operations and could potentially result in materially different results under different assumptions and conditions. The following discussion should be considered in conjunction with the description of our accounting policies in Note 1 to the consolidated financial statements in this Annual Report on Form 10-K.
Allowance for Credit Losses
In the ordinary course of business, we grant non-interest bearing trade credit to our customers on normal credit terms.  In an effort to reduce our credit risk, we (i) establish credit limits for all of our customer relationships, (ii) perform ongoing credit evaluations of our customers’ financial condition, (iii) monitor the payment history and aging of our customers’ receivables, and (iv) monitor open orders against an individual customer’s outstanding receivable balance.
An allowance for credit losses is maintained for trade accounts receivable based on the expected collectability of accounts receivable, after considering our historical collection experience, the length of time an account is outstanding, the financial position of the customer, information provided by credit rating services in addition to new requirements under the accounting guidance, effective January 1, 2020, that includes the consideration of events or circumstances indicating historic collection rates may not be indicative of future collectability, for example, potential customer liquidity concerns resulting from COVID-19, that may impact the collectability of our receivables as well as our estimate of credit losses expected to be incurred over the life of our receivables. Our allowance for credit losses
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was $12.9 million and $9.1 million at December 31, 2020 and 2019, respectively, which constituted 3.0% and 2.1% of gross trade accounts receivable at December 31, 2020 and 2019, respectively. The current portion of the allowance for credit losses, which was $8.1 million and $5.3 million as of December 31, 2020 and 2019, respectively, was recognized as a reduction of accounts receivable, net.
Although we maintain allowance for credit losses to cover the estimated losses which may occur when customers cannot make their required payments, we cannot be assured that the allowances will be sufficient to cover future losses given the volatility in the worldwide economy and the possibility that other, unanticipated events may adversely affect collectability of the accounts. If our allowance for credit losses is insufficient to address receivables we ultimately determine are uncollectible, we would be required to incur additional charges, which could materially adversely affect our results of operations.  Moreover, our inability to collect outstanding receivables could adversely affect our financial condition and cash flow from operations.
Distributor Rebates
We offer rebates to certain distributors and record a reserve with respect to the estimated amount of the rebates as a reduction of revenues at the time of sale. In estimating rebates, we consider the lag time between the point of sale and the payment of the distributor’s rebate claim, distributor-specific trend analyses, contractual commitments, including stated rebate rates, historical experience and other relevant information. When necessary, we adjust the reserves, with a corresponding adjustment to revenue, to reflect differences between estimated and actual experience. Historical adjustments to recorded reserves have not been significant and we do not expect significant revisions to the estimated rebates in the future. The reserve for estimated rebates was $28.5 million and $21.6 million at December 31, 2020 and 2019, respectively. We expect to pay amounts subject to the reserve as of December 31, 2020 within 90 days subsequent to year-end.
Inventory Utilization
Inventories are valued at the lower of cost or net realizable value. Factors utilized in the determination of estimated net realizable value and whether a reserve is required include (i) current sales data and historical return rates, (ii) estimates of future demand, (iii) competitive pricing pressures, (iv) new product introductions, (v) product expiration dates, and (vi) component and packaging obsolescence.
We review the net realizable value of inventory each reporting period and adjustedadjust as necessary.  We regularly compare inventory quantities on hand against historical usage or forecasts related to specific items in order to evaluate obsolescence and excessive quantities. In assessing historical usage, we also qualitatively assess business trends to evaluate the reasonableness of using historical information in estimating future usage. Our inventory reserve was $47.1 million and $42.7 million at December 31, 2022 and 2021, respectively.
Long-Lived Assets
We assess the remaining useful life and recoverability of long-lived assets whenever events or circumstances indicate the carrying value of an asset may not be recoverable. For example, such an assessment may be initiated if, as a result of a change in expectations, we believe it is more likely than not that the asset will be sold or disposed of significantly before the end of its useful life or if an adverse change occurs in the business employing the
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asset. Significant judgments in this area involve determining whether such events or circumstances have occurred and determining the appropriate asset group requiring evaluation. The recoverability evaluation is based on various analyses, including undiscounted cash flow projections, which involve significant management judgment. Any impairment loss, if indicated, equals the amount by which the carrying amount of the asset exceeds the estimated fair value of the asset.
Goodwill and Other Intangible Assets
Intangible assets include indefinite-lived assets (such as goodwill, certain trade names and in-process research and development ("IPR&D")), as well as finite-lived intangibles (such as trade names that do not have indefinite lives, customer relationships, intellectual property, distribution rights and non-competition agreements) and are, generally, obtained through acquisition. Intangible assets acquired in a business combination are measured at fair value and we allocate any excess purchase price over the fair value of the net tangible and intangible assets acquired in a business combination to goodwill. Considerable management judgment is necessary in making the assumptions used in the estimated fair value of intangible assets acquired in a business combination.
The costs of finite-lived intangibles are amortized to expense over their estimated useful life. Determining the useful life of an intangible asset requires considerable judgment as different types of intangible assets typically will
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have different useful lives. Goodwill and other indefinite-lived intangible assets are not amortized; we test these assets annually for impairment during the fourth quarter, using the first day of the quarter as the measurement date, or earlier upon the occurrence of certain events or substantive changes in circumstances that indicate an impairment may have occurred. Such conditions may include an economic downturn in a geographic market or a change in the assessment of future operations.
Goodwill
Goodwill impairment assessments are performed at a reporting unit level. For purposes of this assessment, aour reporting unit is anunits are our operating segment,segments, or, in certain cases, a business one level below thatour operating segment. Nosegments. As the fair values of our reporting units are more likely than not greater than the carrying values, no impairment was recorded as a result of the annual goodwill impairment testing performed during the fourth quarter of 2020.2022.
In applying the goodwill impairment test, we may assess qualitative factors to determine whether it is more likely than not that the fair value of a reporting unit is less than its carrying value. Qualitative factors may include, but are not limited to, macroeconomic conditions, industry conditions, the competitive environment, changes in the market for our products and services, regulatory and political developments, and entity specific factors such as strategies and financial performance. If, after completing the qualitative assessment, we determine it is more likely than not that the fair value of a reporting unit is less than its carrying value, we proceed to a two-step quantitative impairment test, described below test described below. Alternatively, we may test goodwill for impairment through the two-step quantitative impairment test without conducting the qualitative analysis.
The first step of the two-stepUnder a quantitative impairment test is towe compare the fair value of a reporting unit to the carrying value. In performing the first step, weWe calculate the fair value of the reporting unit using equal weightinga combination of two methods; one which estimates the discounted cash flows of the reporting unit based on projected earnings in the future (the Income Approach) and one which is based on salesrevenue and EBITDA of similar businesses to those of the reporting unit in actual transactions (the Market Approach). If the fair value of the reporting unit exceeds the carrying value, there is no impairment. If the reporting unit carrying value exceeds the fair value, we recognize an impairment loss based on the amount by which the carrying value of goodwill exceeds its implied fair value, which we determine in the second step of the two-step test. The implied fair value of goodwill is determined by deducting the fair value of a reporting unit's identifiable assets and liabilities from the fair value of the reporting unit as a whole, as if that reporting unit had just been acquired and theexceeds its fair value of the individual assets acquired and liabilities assumed were being determined initially.value.
The more significant judgments and assumptions in determining fair value using in the Income Approach include (1) the amount and timing of expected future cash flows, which are based primarily on our estimates of future sales, operating income, industry trends and the regulatory environment of the individual reporting units, (2) the expected long-term growth rates for each of our reporting units, which approximate the expected long-term growth rate of the global economy and of the medical device industry, and (3) the discount rates that are used to discountestimate the present value of the future cash flows, to their present values, which are based on an assessment of the risk inherent in the future cash flows of the respective reporting units along with various market based inputs. The more significant judgments and assumptions used in the Market Approach include (1) determination of appropriate revenue and EBITDA multiples used to estimate a reporting unit’s fair value and (2) the selection of appropriate comparable companies to be used for purposes of determining those multiples. There were no changes to the underlying methods used in 20202022 as compared to the valuations of our reporting units in the past several years.
Our expected future growth rates estimated for purposes of the goodwill impairment test are based on our estimates of future sales, operating income and cash flow and are consistent with our internal budgets and business
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plans, which reflect a modest amount of core revenue growth coupled with the successful launch of new products each year; the effect of these growth indicators more than offset volume losses from products that are expected to reach the end of their life cycle. Changes in assumptions underlying the Income Approach could cause a reporting unit's carrying value to exceed its fair value. While we believe our assumed growth rates of sales and cash flows are reasonable, the possibility remains that the revenue growth of a reporting unit may not be as high as expected, and, as a result, the estimated fair value of that reporting unit may decline. In this regard, if our strategy and new products are not successful and we do not achieve anticipated core revenue growth in the future with respect to a reporting unit, the goodwill in the reporting unit may become impaired and, in such case, we may incur material impairment charges. Moreover, changes in revenue and EBITDA multiples in actual transactions from those historically present could result in an assessment that a reporting unit’s carrying value exceeds its fair value, in which case we also may incur material impairment charges.
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Other Intangible Assets
 
Intangible assets are assets acquired that lack physical substance and that meet the specified criteria for recognition apart from goodwill. Management tests indefinite-lived intangible assets for impairment annually, and more frequently if events or changes in circumstances indicate that an impairment may have occurred. Similar to the goodwill impairment test process, we may assess qualitative factors to determine whether it is more likely than not that the fair value of an indefinite-lived intangible asset is less than its carrying value. If, after completing the qualitative assessment, we determine it is more likely than not that the fair value of the indefinite-lived intangible asset is greater than its carrying amount, the asset is not impaired. If we conclude it is more likely than not that the fair value of the indefinite-lived intangible asset is less than the carrying value, we then proceed to a quantitative impairment test, which consists of a comparison of the fair value of the intangible asset to its carrying amount. Alternatively, we may elect to forgo the qualitative analysis and test the indefinite-lived intangible asset for impairment through the quantitative impairment test.
In connection with intangible assets acquired in a business combination and quantitative impairment tests, we determine the estimated fair value using various methods under the Income Approach. The more significant judgementsjudgments and assumptions used in the valuation of intangible assets may include revenue growth rates, royalty rate, discount rate, attrition rate, and EBITDA margin. Each of these factors and assumptions can significantly impact the value of the intangible asset.
We did not record any impairment charges related to intangible assets during the year ended December 31, 2022. During the year ended December 31, 20202021, we recognizedrecorded impairment charges of $21.4$6.7 million related primarily to our decision to abandon intellectual property and other assets relatedprimarily associated with our respiratory product portfolio that were not transferred to Medline as part of the Percuvance percutaneous surgical system product line.Respiratory business divestiture. See "Restructuring and impairment charges" within "Result of Operations" above as well as Note 54 to the consolidated financial statements included in this Annual Report on Form 10-K for additional information on these charges.
Share-based Compensation
We estimate the fair value of share-based awards on the date of grant and recognize as expense the value of the portion of the award that is ultimately expected to vest over the requisite service periods. Share-based compensation expense related to stock options is measured using a Black-Scholes option pricing model that takes into account subjective and complex assumptions with respect to expected life of options, volatility, risk-free interest rate and expected dividend yield. The expected life of options granted represents the period of time that options are expected to be outstanding, which is derived from the vesting period of the award, as well as historical exercise behavior. Expected volatility is based on a blend of historical volatility and implied volatility derived from publicly traded options to purchase our common stock, which we believe is more reflective of market conditions and a better indicator of expected volatility than solely using historical volatility. The risk-free interest rate is the implied yield currently available on U.S. Treasury zero-coupon issues with a remaining term equal to the expected life of the option. Share-based compensation expense related to non-vested restricted stock units is measured based on the market price of the underlying stock on the grant date discounted for the risk free interest rate and the present value of expected dividends over the vesting period. Share based compensation expense for 2020 and 2019 was $20.7 million and $26.9 million, respectively.
Contingent Consideration Liabilities
 
In connection with an acquisition, we may be required to pay future consideration that is contingent upon the achievement of specified objectives, such as receipt of regulatory approval, commercialization of a product or achievement of sales targets. As of the acquisition date,In a business combination, we record a contingent liability, as of the acquisition date, representing the estimated fair value of the contingent consideration we expect to pay. We determined the fair value of the contingent consideration liabilities related to the Standard Bariatrics acquisition, which represented most of our contingent consideration liabilities at December 31, 2022, using a Monte Carlo valuation approach, which simulates future revenues during the earn out-period using management's best estimates andestimates. We determined the fair value of our other probability-weightedcontingent consideration liabilities using a discounted cash flow analysis. Significant judgment is required in determining the assumptions used to calculate the fair value of the contingent consideration. Increases in projected revenues and probabilities of payment may result in significantly higher fair value measurements; decreases in these items may have the opposite effect. Increases in discount rates in the periods prior to payment may result in significantly lower fair value measurements; decreases may have the opposite effect. See Note 12 to the consolidated financial statements included in this Annual Report on Form 10-K for additional information.
We remeasure our contingent consideration liabilities each reporting period and recognize the change in the liabilities' fair value within selling, general and administrative expenses in our consolidated statement of income. As of December 31, 2022 and 2021, we accrued $44.0 million and $9.8 million of contingent consideration, respectively, related to completed business combinations.
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of December 31, 2020 and 2019, we accrued $36.6 million and $219.9 million ofIf the transaction is determined to be an asset acquisition rather than a business combination, a contingent consideration respectively.liability is recognized when the specified objective is deemed probable and is estimable.
Income Taxes
Our annual provision for income taxes and determination of the deferred tax assets and liabilities require management to assess uncertainties, make judgments regarding outcomes and utilize estimates. The difficulties inherent in such assessments, judgments and estimates are particularly challenging because we conduct a broad range of operations around the world, subjecting us to complex tax regulations in numerous international jurisdictions. As a result, we are at times subject to tax audits, disputes with tax authorities and potential litigation, the outcome of which is uncertain. In connection with its estimates of our tax assets and liabilities, management must, among other things, make judgments about the outcome of these uncertain matters.
Deferred tax assets and liabilities are measured and recorded using currently enacted tax rates that are expected to apply to taxable income in the years in which differences between the financial statement carrying amounts of existing assets and liabilities and their tax bases are recovered or settled. The likelihood of a material change in our expected realization of these assets is dependent on future taxable income, our ability to use foreign tax credit carryforwards and carrybacks, final U.S. and non-U.S. tax settlements, changes in tax law, and the effectiveness of our tax planning strategies in the various relevant jurisdictions. While management believes that its judgments and interpretations regarding income taxes are appropriate, significant differences in actual experience may require future adjustments to our tax assets and liabilities, which could be material.  
In assessing the realizability of our deferred tax assets, we evaluate positive and negative evidence and use judgments regarding past and future events, including results of operations and available tax planning strategies that could be implemented to realize the deferred tax assets. Based on this assessment, we determine when it is more likely than not that all or some portion of our deferred tax assets may not be realized, in which case we apply a valuation allowance to offset the amount of such deferred tax assets. To the extent facts and circumstances change in the future, adjustments to the valuation allowances may be required. The valuation allowance for deferred tax assets of $155.0$91.5 million and $119.2$143.2 million at December 31, 20202022 and 2019,2021, respectively, relates principally to the uncertainty of the utilization of tax loss and credit carryforwards in various jurisdictions.
Significant judgment is required in determining income tax provisions and in evaluating tax positions. We establish additional provisions for income taxes when, despite the belief that tax positions are supportable, there remain certain positions that do not meet the minimum probability threshold, which is a tax position that is more likely than not to be sustained upon examination by the applicable taxing authority. In the normal course of business, we are examined by various federal, state and non-U.S. tax authorities. We regularly assess the potential outcomes of these examinations and any future examinations for the current or prior years in determining the adequacy of our provision for income taxes. We adjust the income tax provision, the current tax liability and deferred taxes in any period in which we become aware of facts that necessitate an adjustment. We are currently under examination in IrelandIreland. Germany and Germany.France. The ultimate outcome of this examinationthese examinations could result in increases or decreases to our recorded tax liabilities, which would affect our financial results. See Note 15 to the consolidated financial statements in this Annual Report on Form 10-K for additional information regarding our uncertain tax positions.

New Accounting Standards
 
See Note 2 to the consolidated financial statements included in this Annual Report on Form 10-K for a discussion of recently issued accounting standards, including estimated effects, if any, of the adoption of those standards on our consolidated financial statements.

47


ITEM 7A. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
We are exposed to certain financial risks, specifically fluctuations in market interest rates, foreign currency exchange rates and, to a lesser extent, commodity prices. We address these risks through a risk management program that includes the use of derivative financial instruments. We do not enter into derivative instruments for trading or speculative purposes. We manage our exposure to counterparty risk on derivative instruments by entering into contracts with a diversified group of major financial institutions and by actively monitoring outstanding positions.
We also are exposed to changes in the market trading price of our common stock as it influences the valuation of stock options and their effect on earnings.
43


Interest Rate Risk
We are exposed to changes in interest rates as a result of our borrowing activities and our cash balances. The table below provides information regarding the interest rates by year of maturity for our fixed and variable rate debt obligations. Variable interest rates on December 31, 20202022 were determined using a base rate of the one-month LIBOR rate plus the applicable spread.
Year of Maturity  Year of Maturity  
20212022202320242025ThereafterTotal20232024202520262027ThereafterTotal
Fixed rate debtFixed rate debt$— $— $— $— $— $1,400.0 $1,400.0 Fixed rate debt$— $— $— $— $500 $500.0 $1,000.0 
Average interest rateAverage interest rate— %— %— %— %— %4.563 %4.563 %Average interest rate— %— %— %— %4.625 %4.250 %4.438 %
Variable rate debtVariable rate debt$100.5 $35.0 $43.8 $918.7 $— $— $1,098.0 Variable rate debt$87.5 $12.5 $25.0 $25.0 $573.3 $— $723.3 
Average interest rateAverage interest rate1.346 %1.647 %1.647 %1.651 %— %— %1.623 %Average interest rate5.206 %5.798 %5.798 %5.798 %5.798 %— %5.726 %
A change of 1.0% in variable interest rates would increase or decrease annual interest expense by $11.0$7.2 million based on our outstanding debt as of December 31, 2020.2022.
Foreign Currency Risk
The global nature of our operations exposes us to foreign currency risks. These risks include exposure from the effect of fluctuating exchange rates on payables and receivables as well as intercompany loans relating to transactions that are denominated in currencies other than a location’s functional currency and exposure that arises from translating the results of our worldwide operations to the U.S. dollar at exchange rates that have fluctuated from the beginning of a reporting period. Our principal currency exposures relate to the Euro, Chinese Renminbi, Mexican Peso, Canadian Dollar, MalaysianMalaysia Ringgit, Czech Koruna, Canadian Dollar, and British Pound, Indian Rupee and Japanese Yen.Pound. We utilize foreign currency forward exchange contracts and cross-currency interest rate swap contracts to attempt to minimize our exposure to these risks. Gains and losses on these contracts substantially offset losses and gains on the underlying hedged transactions.
As of December 31, 2020,2022, the total notional amount for the foreign currency forward exchange contracts and cross-currency interest rates swap contracts, expressed in U.S. dollars, was $293.0$337.7 million and $750.0 million, respectively. A sensitivity analysis of changes in fair value of these contracts outstanding as of December 31, 2020,2022, while not predictive in nature, indicated that a hypothetical 10% increase/decrease in the value of the U.S. dollar against all currencies would increase/decrease the fair value of these contracts by $84.5$68.2 million, the majority of which relates to the cross-currency interest rate swap contracts.
See Note 11 to the consolidated financial statements included in this Annual Report on Form 10-K for information regarding the accounting treatment of our foreign currency forward exchange contracts and cross-currency interest rates swap contracts.

ITEM 8.    FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA
The financial statements and supplementary data required by this Item are included herein, commencing on page F-1.

ITEM 9.    CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL DISCLOSURE
None.
48


ITEM 9A. CONTROLS AND PROCEDURES
(a) Evaluation of Disclosure Controls and Procedures
Our management, with the participation of our Chief Executive Officer and Chief Financial Officer, evaluated the effectiveness of our disclosure controls and procedures as of the end of the period covered by this report. Based on that evaluation, the Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures as of the end of the period covered by this report were functioning effectively to provide reasonable assurance that the information required to be disclosed by us in reports filed under the Securities Exchange Act of 1934 is (i) recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms and (ii) accumulated and communicated to our management, including the Chief Executive Officer and Chief Financial Officer, as appropriate to allow timely decisions regarding disclosure. A controls system cannot provide
44


absolute assurance, however, that the objectives of the controls system are met, and no evaluation of controls can provide absolute assurance that all control issues and instances of fraud, if any, within a company have been detected. We acquired HPC and Z-MedicaStandard Bariatrics on February 18, 2020 and December 28, 2020, respectively.September 27, 2022. Consistent with the guidance provided by the staff of the Securities and Exchange Commission, management has excluded these acquisitionsStandard Bariatrics from its assessment of the effectiveness of our internal control over financial reporting as of December 31, 2020.2022. The net revenues attributable to HPC and Z-MedicaStandard Bariatrics from their respective datesthe date of acquisition through December 31, 2020,2022, represent, in the aggregate, less than 1% of our consolidated net revenues for the year then ended, and the total assets (excluding goodwill and intangible assets) attributable to Standard Bariatrics represent, in the aggregate, less than 1% of our consolidated total assets as of December 31, 2020.2022.
(b) Management’s Report on Internal Control Over Financial Reporting
Our management’s report on internal control over financial reporting is set forth on page F-2 of this Annual Report on Form 10-K and is incorporated by reference herein.
(c) Change in Internal Control over Financial Reporting
At the beginning of November 2020, we integrated the enterprise resource planning, or ERP, system used by our Interventional Urology business with our global ERP system. This conversion impacts certain interfaces with our customers and suppliers, resulting in changes to the tools we use to take orders, procure materials, schedule production, remit billings, make payments and perform other business functions. We believe that the expanded utilization of the ERP system and related changes to processes and internal controls will enhance our internal control over financial reporting by improving the efficiency of certain financial and related transaction processes while providing us with the ability to scale our business.
Other than the ERP system upgrade discussed above, noNo change in our internal control over financial reporting occurred during our most recent fiscal quarter that has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting. In connection with our acquisition of Standard Bariatrics, we are in the process of evaluating the acquired company's internal controls to determine the extent to which modifications to Standard Bariatrics' internal controls would be appropriate.
 
ITEM 9B. OTHER INFORMATION
On February 23, 2021,21, 2023, our Board of Directors (the "Board") approved thean amendment and restatement of our Bylaws to:
implement proxy access;
allow annual meetingsto provide our stockholders with the right to call a special meeting of stockholders (the “Special Meeting Amendment”) and to be held solely by meansmake other administrative changes primarily to reflect recent Delaware law developments (the “Administrative Amendments”), in each case as further described below.
Special Meeting Amendment
Prior to this amendment, our Bylaws provided that only the Board could call a special meeting of remote communication as determined by our Board of Directors, in its sole discretion;
update the requirements for stockholder nominations not intended to be included in our proxy statement to require disclosure of any voting commitment on behalf of the proposed nominee; and
reflect certain conforming changes.
In particular, with respect to the implementation of proxy access, the Bylaws were amended to include a new Article II, Section 2.2.2, which permits a stockholder or group of up to 20 stockholders owning 3%stockholders. The Special Meeting Amendment generally provides one or more of our common stockstockholders who have owned continuously for at least three yearsone year at least 20% of all outstanding shares of the Company’s common stock the right to nominate for election to the Board, and include in our proxy materials for our annualcall a special meeting of stockholders, nominees representing the greater of two directors or 20% of the number of directors then serving on the Board (rounding downsubject to the closest whole number), subjectrequirements and procedures set forth in the Special Meeting Amendment.
Administrative Amendments
The Board also approved the Administrative Amendments to certain limitations and provided that such nominating stockholder(s) and nominee(s) satisfythe Bylaws to conform the Company’s notice provision with the applicable requirements specified inDelaware statute and to incorporate a new Delaware law provision related to notices of adjournments, including with respect to remote meetings of stockholders. In addition, the Bylaws.Administrative Amendments provide that any stockholder soliciting proxies from other stockholders must use a proxy card color other than white, which color is reserved for the exclusive use by the Board.
The foregoing description is qualified in its entirety by reference to the Third Amended and Restated Bylaws, thatwhich are attached hereto as Exhibit 3.2 and incorporated herein by reference.

ITEM 9C. DISCLOSURE REGARDING FOREIGN JURISDICTIONS THAT PREVENT INSPECTIONS
None.
49
45


PART III

ITEM 10. DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE
For the information required by this Item 10 with respect to our Executive Officers, see Part I, Item 1. of this report. For the other information required by this Item 10, see “Election Of Directors,” “Nominees for Election to the Board of Directors,” “Corporate Governance” and “Section 16(a) Beneficial Ownership Reporting Compliance,” in the Proxy Statement for our 20212023 Annual Meeting, which information is incorporated herein by reference. The Proxy Statement for our 20212023 Annual Meeting will be filed within 120 days after the end of the fiscal year covered by this Annual Report on Form 10-K.

ITEM 11. EXECUTIVE COMPENSATION
For the information required by this Item 11, see “Compensation Discussion and Analysis,” “Compensation Committee Report,” and “Executive Compensation” in the Proxy Statement for our 20212023 Annual Meeting, which information is incorporated herein by reference.

ITEM 12. SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT AND RELATED STOCKHOLDER MATTERS
For the information required by this Item 12 with respect to beneficial ownership of our common stock, see “Security Ownership of Certain Beneficial Owners and Management” in the Proxy Statement for our 20212023 Annual Meeting, which information is incorporated herein by reference.
The following table sets forth certain information as of December 31, 20202022 regarding our equity plans :plans:
Plan CategoryPlan Category
Number of Securities
to be Issued Upon
Exercise of
Outstanding Options, Warrants and Rights (1)
Weighted-Average
Exercise Price of
Outstanding Options, Warrants and Rights
Number of Securities
Remaining Available for
Future Issuance Under
Equity Compensation
Plans (Excluding
Securities Reflected in Column (A))
Plan Category
Number of Securities
to be Issued Upon
Exercise of
Outstanding Options,
Warrants, and Rights (1)
Weighted-Average
Exercise Price of
Outstanding Options,
Warrants, and Rights
Number of Securities Remaining Available for Future Issuance
Under Equity Compensation
 Plans (Excluding Securities Reflected in Column (A))
(A)(B)(C) (A)(B)(C)
Equity compensation plans approved by security holdersEquity compensation plans approved by security holders1,157,315$195.573,183,199Equity compensation plans approved by security holders1,228,848$230.582,843,121
(1) The number of securities in column (A) exclude 64,56262,927 shares of common stock underlying performance stock units if maximum performance levels are achieved; the actual number of shares, if any, to be issued with respect to the performance stock units will be based on performance with respect to specified financial and relative stock price measures.

ITEM 13. CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS, AND DIRECTOR INDEPENDENCE
For the information required by this Item 13, see “Certain Transactions” and “Corporate Governance” in the Proxy Statement for our 20212023 Annual Meeting, which information is incorporated herein by reference.

ITEM 14. PRINCIPAL ACCOUNTING FEES AND SERVICES
For the information required by this Item 14, see “Audit and Non-Audit Fees” and “Audit Committee Pre-Approval Procedures” in the Proxy Statement for our 20212023 Annual Meeting, which information is incorporated herein by reference.

5046


PART IV
 
 ITEM 15. EXHIBITS, FINANCIAL STATEMENT SCHEDULES

(a)Consolidated Financial Statements:
The Index to Consolidated Financial Statements and Schedule is set forth on page F-1 of this Annual Report on Form 10-K.
(b)Exhibits:

The following exhibits are filed as part of, or incorporated by reference into, this report (unless otherwise
indicated, the file number with respect to each filed document is 1-5353):
Exhibit No.Description
*3.1.13.1
*3.1.2
*3.1.3
3.2
*4.1.1
*4.1.2
*4.1.3
*4.1.4
*4.1.5
*4.1.6
*4.1.74.1.3
*4.1.4
4.1.5
*4.1.6
*4.2.1
*4.2.2
4.2.3
*4.2.4
*4.3

^*10.1
^*10.2.1
Teleflex Incorporated Directors' Deferred Compensation Plan, dated November 22, 2019 (incorporated by reference to Exhibit 10.2.1 to the Company’s Form 10-K filed on February 21, 2020).
^*10.2.2
^*10.3.1
^*10.3.2
5147


Exhibit No.Description
^*10.3.210.3.3
^*10.3.3
^*10.3.4
^*10.3.5
^*10.3.6
^*10.3.7
^*10.4.1
^*10.4.2
^*10.5.1
^*10.5.210.4.2
^*10.5.310.4.3
^*10.610.5
^*10.710.6
^*10.810.7
^*10.910.8
^*10.1010.9
^*10.1110.10
^*10.12
^*10.13
^*10.14
^*10.1510.11
52


Exhibit No.Description
^*10.1610.12
^*10.1710.13
^*10.1810.14
^*10.15
^*10.16
, 20Senior Executive Officer Severance Agreement, dated January 1, 2021, between the Company and Daniel V. Logue (incorporated by reference to Exhibit 10.23 to the Company's Form 10-K filed on February 25, 2021).
^*10.17
^*10.18
^*10.19
^*10.20
^*10.2110.20
^*10.22
10.23
10.24
^*10.25
48


Exhibit No.Description
^*10.2610.21
21
22
23
31.1
31.2
32.1
32.2
101.1The following materials from our Annual Report on Form 10-K for the year ended December 31, 2020,2022, formatted in XBRL (eXtensible Business Reporting Language): (i) the Consolidated Statements of Income for the years ended December 31, 2020,2022, December 31, 20192021 and December 31, 2018;2020; (ii) the Consolidated Statements of Comprehensive Income for the years ended December 31, 2020,2022, December 31, 20192021 and December 31, 2018;2020; (iii) the Consolidated Balance Sheets as of December 31, 20202022 and December 31, 2019;2021; (iv) the Consolidated Statements of Cash Flows for the years ended December 31, 2020,2022, December 31, 20192021 and December 31, 2018;2020; (v) the Consolidated Statements of Changes in Equity for the years ended December 31, 2020,2022, December 31, 20192021 and December 31, 2018;2020; and (vi) Notes to Consolidated Financial Statements.
104.1The cover page of the Company’s Annual Report on Form 10-K for the year ended December 31, 2020,2022, formatted in inline XBRL (included in Exhibit 101.1).

*    Previously filed with the Securities and Exchange Commission as part of the filing indicated and incorporated herein by reference.
^    Indicates management contract or compensatory plan or arrangement required to be filed pursuant to Item 15(b) of this report.

 ITEM 16. FORM 10-K SUMMARY
Registrants may voluntarily include a summary of information required by Form 10-K under this Item 16. We have elected not to include such summary information.
5349


SIGNATURES
Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this Annual Report to be signed on its behalf by the undersigned, thereunto duly authorized as of the date indicated below.
TELEFLEX INCORPORATED
By:/s/ Liam J. Kelly
Liam J. Kelly
Chairman, President and Chief Executive Officer
Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the following persons on behalf of the registrant and in the capacities and as of the date indicated below.
By:/s/ Liam J. KellyBy:/s/ Thomas E. Powell
Liam J. KellyThomas E. Powell
Chairman, President, Chief Executive Officer and Director
Executive Vice President and Chief 
Financial Officer
(Principal Executive Officer)(Principal Financial Officer)
By:/s/ John R. Deren
John R. Deren
Corporate Vice President and Chief Accounting Officer
(Principal Accounting Officer)

By:/s/ George Babich, Jr.By:/s/ Dr. Stephen K. Klasko
George Babich, Jr.
Director
Dr. Stephen K. Klasko
Director
By:/s/ Candace H. DuncanBy:/s/ Andrew A. Krakauer
Candace H. Duncan
Director
Andrew A. Krakauer
Director
By:/s/ Gretchen R. HaggertyBy:/s/ Richard A. PackerNeena M. Patil
Gretchen R. Haggerty
Director
Richard A. PackerNeena M. Patil
Director
By:/s/ John C. HeinmillerBy:/s/ Stuart A. Randle
John C. Heinmiller
Director
Stuart A. Randle
Director
Dated: February 25, 202123, 2023
5450



TELEFLEX INCORPORATED
INDEX TO CONSOLIDATED FINANCIAL STATEMENTS

 Page
Management's Report on Internal Control over Financial Reporting
Report of Independent Registered Public Accounting Firm (PCAOB ID 238)
Consolidated Statements of Income for the years ended December 31, 2020, 20192022, 2021 and 20182020
Consolidated Statements of Comprehensive Income for the years ended December 31, 2020, 20192022, 2021 and 20182020
Consolidated Balance Sheets as of December 31, 20202022 and 20192021
Consolidated Statements of Cash Flows for the years ended December 31, 2020, 20192022, 2021 and 20182020
Consolidated Statements of Changes in Shareholders' Equity as of and for the years ended December 31, 2020, 20192022, 2021 and 20182020
Notes to Consolidated Financial Statements
Quarterly Data
FINANCIAL STATEMENT SCHEDULE
 Page
Schedule II Valuation and qualifying accounts as of and for the years ended December 31, 2020, 20192022, 2021 and 20182020

F-1


MANAGEMENT’S REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING
The management of Teleflex Incorporated and its subsidiaries (the “Company”) is responsible for establishing and maintaining adequate internal control over financial reporting. Internal control over financial reporting is a process designed by, or under the supervision of our Chief Executive Officer and Chief Financial Officer and effected by the Company's board of directors, management and other personnel, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company’s internal control over financial reporting includes those policies and procedures that pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial statements.
Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.
Management assessed the effectiveness of the Company’s internal control over financial reporting as of December 31, 2020.2022. In making this assessment, management used the framework established in Internal Control — Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). As a result of this assessment and based on the criteria in the COSO framework, management has concluded that, as of December 31, 2020,2022, the Company’s internal control over financial reporting was effective.
The Company acquired IWG High Performance Conductors, Inc. (“HPC”) and Z-Medica, LLC. ("Z-Medica")Standard Bariatrics on February 18, 2020 and December 28, 2020.September 27, 2022. Management has excluded HPC and Z-MedicaStandard Bariatrics from its assessment of internal control over financial reporting as of December 31, 2020.2022. The net revenues attributable to HPC and Z-MedicaStandard Bariatrics from their respective dates of acquisition through December 31, 2020,2022, represent, in the aggregate, less than 1% of our consolidated net revenues for the year then ended and total assets (excluding goodwill and intangible assets) attributable to Standard Bariatrics represent, in the aggregate, less than 1% of our consolidated total assets as of December 31, 2020.2022.
The effectiveness of the Company’s internal control over financial reporting as of December 31, 20202022 has been audited by PricewaterhouseCoopers LLP, an independent registered public accounting firm, as stated in their report which appears herein.
/s/ Liam J. Kelly/s/ Thomas E. Powell
Liam J. Kelly

Chairman, President and Chief Executive Officer
Thomas E. Powell
 
Executive Vice President and Chief Financial Officer
February 25, 202123, 2023

F-2


REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

To the Board of Directors and Shareholders of Teleflex Incorporated
Opinions on the Financial Statements and Internal Control over Financial Reporting
We have audited the consolidated financial statements, including the related notes and financial statement schedule, of Teleflex Incorporated and its subsidiaries (the “Company”) as listed in the accompanying index (collectively referred to as the “consolidated financial statements”). We also have audited the Company's internal control over financial reporting as of December 31, 2020,2022, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).
In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of the Company as of December 31, 20202022 and 2019,2021, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 20202022 in conformity with accounting principles generally accepted in the United States of America. Also in our opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of December 31, 2020,2022, based on criteria established in Internal Control - Integrated Framework (2013) issued by the COSO.
Change in Accounting Principle

As discussed in Note 1 to the consolidated financial statements, the Company changed the manner in which it accounts for leases in 2019.

Basis for Opinions
The Company's management is responsible for these consolidated financial statements, for maintaining effective internal control over financial reporting, and for its assessment of the effectiveness of internal control over financial reporting, included in the accompanying Management’s Report on Internal Control Over Financial Reporting. Our responsibility is to express opinions on the Company’s consolidated financial statements and on the Company's internal control over financial reporting based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether due to error or fraud, and whether effective internal control over financial reporting was maintained in all material respects.

Our audits of the consolidated financial statements included performing procedures to assess the risks of material misstatement of the consolidated financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements. Our audit of internal control over financial reporting included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, and testing and evaluating the design and operating effectiveness of internal control based on the assessed risk. Our audits also included performing such other procedures as we considered necessary in the circumstances. We believe that our audits provide a reasonable basis for our opinions.

As described in Management’s Report on Internal Control Overover Financial Reporting, management has excluded IWG High Performance Conductors, Inc. and Z-Medica, LLCStandard Bariatrics from its assessment of internal control over financial reporting as of December 31, 20202022 because they wereit was acquired by the Company in a purchase business combinationscombination during 2020.2022. We have also excluded IWG High Performance Conductors, Inc. and Z-Medica, LLCStandard Bariatrics from our audit of internal control over financial reporting. IWG High Performance Conductors, Inc. and Z-Medica, LLC areStandard Bariatrics is a wholly-owned subsidiariessubsidiary whose total assets and total revenues excluded from management’s assessment and our audit of internal control over financial reporting represent less than 1% and 1% respectively, of the related consolidated financial statement amounts as of and for the year ended December 31, 2020.2022.

Definition and Limitations of Internal Control over Financial Reporting
A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in
F-3


accordance with generally accepted accounting principles. A company’s internal control over financial reporting
F-3


includes those policies and procedures that (i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; (ii) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and (iii) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial statements.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.

Critical Audit Matters

The critical audit matter communicated below is a matter arising from the current period audit of the consolidated financial statements that was communicated or required to be communicated to the audit committee and that (i) relates to accounts or disclosures that are material to the consolidated financial statements and (ii) involved our especially challenging, subjective, or complex judgments. The communication of critical audit matters does not alter in any way our opinion on the consolidated financial statements, taken as a whole, and we are not, by communicating the critical audit matter below, providing a separate opinion on the critical audit matter or on the accounts or disclosures to which it relates.

Acquisition of Standard Bariatrics, Inc. - Valuation of Intellectual Property Intangible Assets Acquired in Business Combinationsand Contingent Consideration

As described in NoteNotes 4 and 12 to the consolidated financial statements, the Company completed the acquisitionsacquisition of IWG High Performance Conductors,Standard Bariatrics, Inc. (“HPC”Standard Bariatrics”) and Z-Medica, LLC (“Z-Medica”) for neton September 27, 2022. The fair value of consideration transferred was $211.8 million, which included cash payments of $260.0$173.0 million and $500.0$38.8 million respectively, in 2020, which resultedestimated fair value of contingent consideration. The fair value of the contingent consideration was estimated using a Monte Carlo valuation approach. Inputs and assumptions used in $511.0 milliondetermining the fair value of intangible assets being recorded. Thecontingent consideration liabilities include revenue growth rates (based on internal operational budgets and long-range strategic plans), revenue volatility, discount rates, probability of payment and projected payment dates. Identifiable intangible assets acquired were comprisedincluded $128.3 million of intellectual property and customer relationships for both HPC and Z-Medica, and trade names for Z-Medica.intangible assets. As disclosed by management, the fair value of intangible assets acquired is determinedin a business combination are measured at fair value using various methods under the income approach. The more significant judgments and assumptions used in the valuation of intangible assets may include revenue growth rates, royalty rate, discount rate, attrition rate, and EBITDA margin.

The principal considerations for our determination that performing procedures relating to the valuation of intellectual property intangible assets acquired in business combinationsand contingent consideration related to the acquisition of Standard Bariatrics is a critical audit matter are (i) the significant judgment by management in determiningwhen developing the fair value estimates of acquiredthe intellectual property intangible assets;assets and contingent consideration; (ii) a high degree of auditor judgment, subjectivity, and effort in performing procedures relating to the fair value measurement of intangible assets acquired and evaluating themanagement’s significant assumptions related to revenue growth rates, royalty rates, discount rates, attrition rates,rate, and EBITDA margins;margin for the intellectual property intangible assets and revenue growth rates, revenue volatility, discount rate, probability of payment and projected payment dates for the contingent consideration; and (iii) the audit effort involved the use of professionals with specialized skill and knowledge.

Addressing the matter involved performing procedures and evaluating audit evidence in connection with forming our overall opinion on the consolidated financial statements. These procedures included testing of the effectiveness of controls relating to the acquisition accounting, including controls over management’s valuation of the intellectual property intangible assets.assets and contingent consideration related to the acquisition. These procedures also included, among others (i) reading the purchase agreement and (ii) testing management’s process for estimatingdeveloping the fair value estimates of the intellectual property intangible assets.assets and contingent consideration. Testing management’s process included evaluating the appropriateness of the valuation methods, testing the completeness and accuracy of data provided by management,used in the valuation methods, and evaluating the reasonableness of the revenue growth rates, royalty rates, discount rates, attrition rates, and EBITDA margins.aforementioned significant assumptions. Evaluating the reasonableness ofmanagement’s significant assumptions related to the revenue growth rates, attrition rates,revenue volatility and EBITDA margins involved considering the current and past performance of the acquired businesses, as well asStandard Bariatrics business, the consistency with economic and industry forecasts. The royalty ratesdata, and whether these assumptions were evaluated by considering historical and current royalty ratesconsistent with evidence obtained in other areas of similar intangible assets in the industry. The discount rates were evaluated byaudit. Evaluating management’s significant assumption related to projected
F-4


payment dates involved evaluating whether the assumption used was reasonable considering the costterms of capital of comparable businesses and other industry factors.the purchase agreement. Professionals with specialized skill and knowledge were used to assist in evaluating the appropriateness of the valuation methods and evaluating the reasonableness of the discount rate for the intellectual property intangible assets and the revenue growth rates, EBITDA margins, the royalty rates, attrition rates,volatility, probability of payment and discount rates.rate for the contingent consideration.
/s/ PricewaterhouseCoopers LLP
Philadelphia, Pennsylvania
February 25, 202123, 2023

We have served as the Company’s auditor since 1962.

F-4F-5


TELEFLEX INCORPORATED
CONSOLIDATED STATEMENTS OF INCOME
 Year Ended December 31,
 202020192018
 
(Dollars and shares in thousands, except
 per share)
Net revenues$2,537,156 $2,595,362 $2,448,383 
Cost of goods sold1,212,282 1,186,357 1,145,567 
Gross profit1,324,874 1,409,005 1,302,816 
Selling, general and administrative expenses743,568 851,766 797,062 
Research and development expenses119,747 113,857 106,208 
Restructuring and impairment charges38,491 22,205 79,230 
Gain on sale of assets(6,077)(1,388)
Income from continuing operations before interest, loss on extinguishment of debt and taxes423,068 427,254 321,704 
Interest expense66,494 80,270 103,020 
Interest income(1,158)(1,741)(944)
Loss on extinguishment of debt8,822 
Income from continuing operations before taxes357,732 339,903 219,628 
Taxes (benefit) on income from continuing operations21,931 (122,078)23,196 
Income from continuing operations335,801 461,981 196,432 
(Loss) income from discontinued operations(621)(828)5,643 
(Benefit) taxes on (loss) income from discontinued operations(144)(313)1,273 
(Loss) income on discontinued operations(477)(515)4,370 
Net income$335,324 $461,466 $200,802 
Earnings per share:
Basic:
Income from continuing operations$7.22 $10.00 $4.30 
(Loss) income on discontinued operations(0.01)(0.01)0.09 
Net income$7.21 $9.99 $4.39 
Diluted:
Income from continuing operations$7.10 $9.81 $4.20 
(Loss) income on discontinued operations(0.01)(0.01)0.09 
Net income$7.09 $9.80 $4.29 
Weighted average shares outstanding:
Basic46,488 46,200 45,689 
Diluted47,287 47,090 46,801 
 Year Ended December 31,
 202220212020
(Dollars and shares in thousands, except
 per share)
Net revenues$2,791,041 $2,809,563 $2,537,156 
Cost of goods sold1,259,954 1,259,961 1,212,282 
Gross profit1,531,087 1,549,602 1,324,874 
Selling, general and administrative expenses863,748 860,085 743,568 
Research and development expenses153,819 130,841 119,747 
Restructuring and impairment charges20,299 21,738 38,491 
Gain on sale of assets and business(6,504)(91,157)— 
Income from continuing operations before interest, loss on extinguishment of debt and taxes499,725 628,095 423,068 
Interest expense54,264 56,969 66,494 
Interest income(912)(1,328)(1,158)
Loss on extinguishment of debt454 12,986 — 
Income from continuing operations before taxes445,919 559,468 357,732 
Taxes on income from continuing operations83,003 74,349 21,931 
Income from continuing operations362,916 485,119 335,801 
Operating income (loss) from discontinued operations260 331 (621)
Taxes (benefit) on operating loss from discontinued operations37 76 (144)
Income (loss) from discontinued operations223 255 (477)
Net income$363,139 $485,374 $335,324 
Earnings per share:
Basic:
Income from continuing operations$7.74 $10.37 $7.22 
Income (loss) from discontinued operations— 0.01 (0.01)
Net income$7.74 $10.38 $7.21 
Diluted:
Income from continuing operations$7.67 $10.23 $7.10 
Income (loss) from discontinued operations0.01 — (0.01)
Net income$7.68 $10.23 $7.09 
Weighted average shares outstanding:
Basic46,898 46,774 46,488 
Diluted47,309 47,427 47,287 
The accompanying notes are an integral part of the consolidated financial statements.
F-5F-6


TELEFLEX INCORPORATED
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
Year Ended December 31,
 202020192018
 (Dollars in thousands)
Net income$335,324 $461,466 $200,802 
Other comprehensive income, net of tax:
Foreign currency:
Foreign currency translation adjustments, net of tax of $6,442, $(6,270) and $(1,047), respectively59,758 4,195 (83,889)
Foreign currency translation, net of tax59,758 4,195 (83,889)
Pension and other postretirement benefits plans:
Prior service cost recognized in net periodic cost, net of tax of $(7), $(20) and $(23), respectively26 62 71 
Unamortized (loss) gain arising during the period, net of tax of $6,101, $3,817 and $(447), respectively(19,966)(12,767)1,116 
Plan amendments, curtailments, and settlements, net of tax of $(1,067), $0 and $(137), respectively3,544 511 
Net loss recognized in net periodic cost, net of tax of $(1,694), $(1,611) and $(1,588), respectively5,559 5,319 5,231 
Foreign currency translation, net of tax of $243, $15 and $(183), respectively(610)(44)499 
Pension and other postretirement benefits plans adjustment, net of tax(11,447)(7,430)7,428 
Derivatives qualifying as hedges:
Unrealized (loss) gain on derivatives arising during the period, net of tax $234, $(85) and $(268), respectively(3,331)1,062 2,574 
Reclassification adjustment on derivatives included in net income, net of tax of $(240), $150 and $163, respectively2,114 (1,134)(2,107)
Derivatives qualifying as hedges, net of tax(1,217)(72)467 
 Other comprehensive income (loss), net of tax47,094 (3,307)(75,994)
 Comprehensive income$382,418 $458,159 $124,808 
Year Ended December 31,
 202220212020
 (Dollars in thousands)
Net income$363,139 $485,374 $335,324 
Other comprehensive income, net of tax:
Foreign currency:
Foreign currency translation adjustments, net of tax of $(6,634), $(5,563) and $6,442, respectively(62,904)(63,191)59,758 
Foreign currency translation, net of tax(62,904)(63,191)59,758 
Pension and other postretirement benefits plans:
Prior service cost recognized in net periodic cost, net of tax of $232, $232 and $(7), respectively(785)(780)26 
Unamortized (loss) gain arising during the period, net of tax of $850, $(1,671) and $6,101, respectively(3,649)5,582 (19,966)
Plan amendments, curtailments, and settlements, net of tax of $0, $0 and $(1,067), respectively— — 3,544 
Net loss recognized in net periodic cost, net of tax of $(1,778), $(1,988) and $(1,694), respectively5,882 6,555 5,559 
Foreign currency translation, net of tax of $(366), $(238) and $243, respectively1,043 610 (610)
Pension and other postretirement benefits plans adjustment, net of tax2,491 11,967 (11,447)
Derivatives qualifying as hedges:
Unrealized gain (loss) on derivatives arising during the period, net of tax $(551), $(27) and $234, respectively7,179 351 (3,331)
Reclassification adjustment on derivatives included in net income, net of tax of $203, $62 and $(240), respectively(3,329)1,212 2,114 
Derivatives qualifying as hedges, net of tax3,850 1,563 (1,217)
 Other comprehensive (loss) income, net of tax(56,563)(49,661)47,094 
 Comprehensive income$306,576 $435,713 $382,418 
  
The accompanying notes are an integral part of the consolidated financial statements.

F-6


TELEFLEX INCORPORATED
CONSOLIDATED BALANCE SHEETS
December 31,
20202019
(Dollars and shares in thousands, except per share)
ASSETS
Current assets
Cash and cash equivalents$375,880 $301,083 
Accounts receivable, net395,071 418,673 
Inventories513,196 476,557 
Prepaid expenses and other current assets115,436 97,943 
Prepaid taxes22,842 12,076 
Total current assets1,422,425 1,306,332 
Property, plant and equipment, net473,912 430,719 
Operating lease assets100,635 113,160 
Goodwill2,585,966 2,245,305 
Intangibles assets, net2,519,746 2,156,285 
Deferred tax assets8,073 5,572 
Other assets41,802 52,447 
Total assets$7,152,559 $6,309,820 
LIABILITIES AND EQUITY
Current liabilities
Current borrowings$100,500 $50,000 
Accounts payable102,520 102,916 
Accrued expenses136,276 100,466 
Current portion of contingent consideration20,543 148,090 
Payroll and benefit-related liabilities122,366 115,981 
Accrued interest7,135 5,514 
Income taxes payable17,361 6,692 
Other current liabilities33,326 33,396 
Total current liabilities540,027 563,055 
Long-term borrowings2,377,888 1,858,943 
Deferred tax liabilities484,678 439,558 
Pension and postretirement benefit liabilities74,499 82,719 
Noncurrent liability for uncertain tax positions10,127 10,294 
Noncurrent contingent consideration16,090 71,818 
Noncurrent operating lease liabilities86,097 101,372 
Other liabilities226,696 202,741 
Total liabilities3,816,102 3,330,500 
Commitments and contingencies00
Shareholders’ equity
Common shares, $1 par value Issued: 2020 — 47,812 shares; 2019 — 47,536 shares47,812 47,536 
Additional paid-in capital652,305 616,980 
Retained earnings3,096,228 2,824,916 
Accumulated other comprehensive loss(297,298)(344,392)
 3,499,047 3,145,040 
Less: Treasury stock, at cost162,590 165,720 
Total shareholders' equity3,336,457 2,979,320 
Total liabilities and shareholders' equity$7,152,559 $6,309,820 
The accompanying notes are an integral part of the consolidated financial statements.
F-7


TELEFLEX INCORPORATED
CONSOLIDATED STATEMENTS OF CASH FLOWS
 Year Ended December 31,
 202020192018
 (Dollars in thousands)
Cash flows from operating activities of continuing operations:
Net income$335,324 $461,466 $200,802 
Adjustments to reconcile net income to net cash provided by operating activities:
Loss (Income) from discontinued operations477 515 (4,370)
Depreciation expense68,567 64,088 60,494 
Intangible asset amortization expense158,685 149,974 149,486 
Deferred financing costs and debt discount amortization expense4,430 4,307 4,734 
Loss on extinguishment of debt8,822 
Fair value step up of acquired inventory sold1,707 
Changes in contingent consideration(38,164)53,915 52,977 
Asset impairments21,388 6,966 19,110 
Stock-based compensation20,739 26,940 22,438 
Net gain on sales of businesses and assets(6,077)(1,388)
Deferred income taxes, net(32,675)(168,594)(6,097)
Payments for contingent consideration(79,801)(26,092)(2,100)
Interest benefit on swaps designated as net investment hedges(19,178)(18,866)(3,277)
Other(26,636)(5,800)(13,426)
Changes in operating assets and liabilities, net of effects of acquisitions and disposals:
Accounts receivable44,748 (59,793)(23,412)
Inventories(5,497)(53,170)(37,198)
Prepaid expenses and other current assets(4,323)(31,023)(10,351)
Accounts payable, accrued expenses and other liabilities646 36,021 62,404 
Income taxes receivable and payable, net(13,294)(6,531)(35,740)
Net cash provided by operating activities from continuing operations437,143 437,068 435,086 
Cash flows from investing activities of continuing operations:
Expenditures for property, plant and equipment(90,694)(102,695)(80,795)
Payments for businesses and intangibles acquired, net of cash acquired(767,830)(3,462)(121,025)
Proceeds from sales of businesses and assets1,400 14,345 3,878 
Net interest proceeds on swaps designated as net investment hedges19,341 18,331 1,548 
Net cash used in investing activities from continuing operations(837,783)(73,481)(196,394)
Cash flows from financing activities of continuing operations:
Proceeds from new borrowings1,513,807 275,000 35,000 
Reduction in borrowings(938,807)(528,500)(128,500)
Debt extinguishment, issuance and amendment fees(8,440)(11,635)(188)
Proceeds from share based compensation plans and the related tax impacts18,994 21,206 22,655 
Payments for contingent consideration(67,170)(112,079)(73,235)
Dividends(63,221)(62,828)(62,165)
Net cash provided by (used in) financing activities from continuing operations455,163 (418,836)(206,433)
Cash flows from discontinued operations:
Net cash (used in) provided by operating activities(737)2,457 2,292 
Net cash (used in) provided by discontinued operations(737)2,457 2,292 
Effect of exchange rate changes on cash and cash equivalents21,011 (3,286)(10,948)
Net increase (decrease) in cash and cash equivalents74,797 (56,078)23,603 
Cash and cash equivalents at the beginning of the year301,083 357,161 333,558 
Cash and cash equivalents at the end of the year$375,880 $301,083 $357,161 
BALANCE SHEETS
December 31,
20222021
(Dollars and shares in thousands, except per share)
ASSETS
Current assets
Cash and cash equivalents$292,034 $445,084 
Accounts receivable, net408,834 383,569 
Inventories578,507 477,643 
Prepaid expenses and other current assets125,084 117,277 
Prepaid taxes6,524 5,545 
Total current assets1,410,983 1,429,118 
Property, plant and equipment, net447,205 443,758 
Operating lease assets131,211 129,653 
Goodwill2,536,730 2,504,202 
Intangibles assets, net2,306,165 2,289,067 
Deferred tax assets6,402 6,820 
Other assets89,367 69,104 
Total assets$6,928,063 $6,871,722 
LIABILITIES AND EQUITY
Current liabilities
Current borrowings$87,500 $110,000 
Accounts payable126,807 118,236 
Accrued expenses140,644 163,441 
Payroll and benefit-related liabilities133,092 143,657 
Accrued interest5,332 5,209 
Income taxes payable24,736 83,943 
Other current liabilities63,381 55,633 
Total current liabilities581,492 680,119 
Long-term borrowings1,624,023 1,740,102 
Deferred tax liabilities388,886 370,124 
Pension and postretirement benefit liabilities31,394 45,185 
Noncurrent liability for uncertain tax positions5,805 8,646 
Noncurrent operating lease liabilities120,437 116,033 
Other liabilities154,058 156,765 
Total liabilities2,906,095 3,116,974 
Commitments and contingencies
Shareholders’ equity
Common shares, $1 par value Issued: 2022 — 47,957 shares; 2021 — 47,929 shares47,957 47,929 
Additional paid-in capital715,118 693,090 
Retained earnings3,817,304 3,517,954 
Accumulated other comprehensive loss(403,522)(346,959)
 4,176,857 3,912,014 
Less: Treasury stock, at cost154,889 157,266 
Total shareholders' equity4,021,968 3,754,748 
Total liabilities and shareholders' equity$6,928,063 $6,871,722 
The accompanying notes are an integral part of the consolidated financial statements.
F-8


TELEFLEX INCORPORATED
CONSOLIDATED STATEMENTS OF CASH FLOWS
 Year Ended December 31,
 202220212020
 (Dollars in thousands)
Cash flows from operating activities of continuing operations:
Net income$363,139 $485,374 $335,324 
Adjustments to reconcile net income to net cash provided by operating activities:
(Income) loss from discontinued operations(223)(255)477 
Depreciation expense66,502 71,758 68,567 
Intangible asset amortization expense164,088 165,604 158,685 
Deferred financing costs and debt discount amortization expense4,053 4,493 4,430 
Loss on extinguishment of debt454 12,986 — 
Fair value step up of acquired inventory sold— 3,993 1,707 
Changes in contingent consideration2,350 8,475 (38,164)
Assets impairment charges1,497 6,739 21,388 
Stock-based compensation27,224 22,937 20,739 
Gain on sale of assets and business(6,504)(91,157)— 
Deferred income taxes, net(13,008)(110,239)(32,675)
Payments for contingent consideration(3,016)(230)(79,801)
Interest benefit on swaps designated as net investment hedges(20,880)(19,296)(19,178)
Other(2,906)(36,388)(26,636)
Changes in operating assets and liabilities, net of effects of acquisitions and disposals:
Accounts receivable(38,459)(600)44,748 
Inventories(110,686)(11,138)(5,497)
Prepaid expenses and other current assets13,420 (28,410)(4,323)
Accounts payable, accrued expenses and other liabilities(24,786)94,020 646 
Income taxes(79,453)73,473 (13,294)
Net cash provided by operating activities from continuing operations342,806 652,139 437,143 
Cash flows from investing activities of continuing operations:
Expenditures for property, plant and equipment(79,190)(71,618)(90,694)
Payments for businesses and intangibles acquired, net of cash acquired(198,429)(4,590)(767,830)
Proceeds from sales of business and assets12,434 224,909 1,400 
Net interest proceeds on swaps designated as net investment hedges20,775 19,154 19,341 
Proceeds from sales of investments7,300 7,300 — 
Purchase of investments(22,300)(18,418)— 
Net cash (used in) provided by investing activities from continuing operations(259,410)156,737 (837,783)
Cash flows from financing activities of continuing operations:
Proceeds from new borrowings744,250 400,000 1,513,807 
Reduction in borrowings(884,500)(1,034,500)(938,807)
Debt extinguishment, issuance and amendment fees(5,200)(9,774)(8,440)
Net proceeds from share based compensation plans and the related tax impacts(4,308)12,451 18,994 
Payments for contingent consideration(3,959)(31,448)(67,170)
Dividends paid(63,789)(63,648)(63,221)
Proceeds from sale of treasury stock— 11,097 — 
Net cash (used in) provided by financing activities from continuing operations(217,506)(715,822)455,163 
Cash flows from discontinued operations:
Net cash used in operating activities(665)(720)(737)
Net cash provided by investing activities1,469 — — 
Net cash provided by (used in) discontinued operations804 (720)(737)
Effect of exchange rate changes on cash and cash equivalents(19,744)(23,130)21,011 
Net (decrease) increase in cash and cash equivalents(153,050)69,204 74,797 
Cash and cash equivalents at the beginning of the year445,084 375,880 301,083 
Cash and cash equivalents at the end of the year$292,034 $445,084 $375,880 
The accompanying notes are an integral part of the consolidated financial statements.
F-9


TELEFLEX INCORPORATED
CONSOLIDATED STATEMENTS OF CHANGES IN SHAREHOLDERS' EQUITY
Common Stock
Additional
Paid in
Capital
Retained
Earnings
Accumulated
Other Comprehensive
Income (loss)
Treasury StockTotal Shareholders' Equity
 SharesDollarsSharesDollars
 (Dollars and shares in thousands, except per share amounts)
Balance at December 31, 201746,871 $46,871 $591,721 $2,285,886 $(265,091)1,704 $(228,856)$2,430,531 
Cumulative effect adjustment resulting from the adoption of new accounting standards3,076 3,076 
Net income200,802 200,802 
Cash dividends ($1.36 per share)(62,165)(62,165)
Other comprehensive loss(75,994)(75,994)
Settlement of warrants(56,115)(412)56,075 (40)
Shares issued under compensation plans377 377 38,756 (50)3,766 42,899 
 Deferred compensation399 (10)470 869 
Balance at December 31, 201847,248 47,248 574,761 2,427,599 (341,085)1,232 (168,545)2,539,978 
Cumulative effect adjustment resulting from the adoption of new accounting standards(1,321)(1,321)
Net income461,466 461,466 
Cash dividends ($1.36 per share)(62,828)(62,828)
Other comprehensive loss(3,307)(3,307)
Shares issued under compensation plans288 288 42,092 (46)2,572 44,952 
 Deferred compensation127 (4)253 380 
Balance at December 31, 201947,536 47,536 616,980 2,824,916 (344,392)1,182 (165,720)2,979,320 
Cumulative effect adjustment resulting from the adoption of new accounting standards(791)(791)
Net income335,324 335,324 
Cash dividends ($1.36 per share)(63,221)(63,221)
Other comprehensive income47,094 47,094 
Shares issued under compensation plans276 276 35,223 (44)2,233 37,732 
Deferred compensation102 (6)897 999 
Balance at December 31, 202047,812 $47,812 $652,305 $3,096,228 $(297,298)1,132 $(162,590)$3,336,457 
Common Stock
Additional
Paid in
Capital
Retained
Earnings
Accumulated
Other Comprehensive
Loss (income)
Treasury StockTotal Shareholders' Equity
 SharesDollarsSharesDollars
 (Dollars and shares in thousands, except per share amounts)
Balance at December 31, 201947,536 $47,536 $616,980 $2,824,916 $(344,392)1,182 $(165,720)$2,979,320 
Cumulative effect adjustment resulting from the adoption of new accounting standards(791)(791)
Net income335,324 335,324 
Cash dividends ($1.36 per share)(63,221)(63,221)
Other comprehensive loss47,094 47,094 
Shares issued under compensation plans276 276 35,223 (44)2,233 37,732 
 Deferred compensation102 (6)897 999 
Balance at December 31, 202047,812 47,812 652,305 3,096,228 (297,298)1,132 (162,590)3,336,457 
Net income485,374 485,374 
Cash dividends ($1.36 per share)(63,648)(63,648)
Other comprehensive income(49,661)(49,661)
Shares issued under compensation plans117 117 33,989 (31)347 34,453 
Treasury stock reissued— — 6,349 (28)4,748 11,097 
 Deferred compensation447 (4)229 676 
Balance at December 31, 202147,929 47,929 693,090 3,517,954 (346,959)1,069 (157,266)3,754,748 
Net income363,139 363,139 
Cash dividends ($1.36 per share)(63,789)(63,789)
Other comprehensive income(56,563)(56,563)
Shares issued under compensation plans28 28 21,930 (32)1,544 23,502 
Deferred compensation98 (5)833 931 
Balance at December 31, 202247,957 $47,957 $715,118 $3,817,304 $(403,522)1,032 $(154,889)$4,021,968 

The accompanying notes are an integral part of the consolidated financial statements.

F-9F-10


TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
 (all tabular amounts in thousands unless otherwise noted)
Note 1 — Summary of significant accounting policies
Consolidation: The consolidated financial statements include the accounts of Teleflex Incorporated and its subsidiaries (referred to herein as “we,” “us,” “our” and “Teleflex"). Intercompany transactions are eliminated in consolidation. These consolidated financial statements have been prepared in conformity with accounting principles generally accepted in the United States of America ("GAAP") and reflect management’s estimates and assumptions that affect the recorded amounts.
Use of estimates: The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of net revenues and expenses during the reporting period. ActualAccordingly, actual results could differ from those estimates.
Cash and cash equivalents: All highly liquid debt instruments with an original maturity of three months or less are classified as cash equivalents. The carrying value of cash equivalents approximates the current market value.
Accounts receivable: Accounts receivable represent amounts due from customers related to the sale of products and provision of services. Our allowance for credit losses is maintained for trade accounts receivable based on the expected collectability of accounts receivable after consideringand losses expected to be incurred over the life of our receivables. Considerations to determine credit losses include our historical collection experience, the length of time an account is outstanding, the financial position of the customer, information provided by credit rating services, in addition to new requirements under the accounting guidance, effective January 1, 2020, that includesas well as the consideration of events or circumstances indicating historic collection rates may not be indicative of future collectability, for example, potential customer liquidity concerns resulting from COVID-19, that may impact the collectability of our receivables as well as our estimate of credit losses expected to be incurred over the life of our receivables.collectability. The allowance for credit losses as of December 31, 20202022 and December 31, 20192021 was $12.9$8.6 million and $9.1$10.8 million, respectively. The current portion of the allowance for credit losses, which was $8.1$4.9 million and $5.3$6.0 million as of December 31, 20202022 and December 31, 2019,2021, respectively, was recognized as a reduction of accounts receivable, net.
Inventories: Inventories are valued at the lower of cost or net realizable value. The cost of our inventories is determined using the average cost method. Elements of cost in inventory include raw materials, direct labor, and manufacturing overhead. In estimating net realizable value, we evaluate inventory for excess and obsolete quantities based on estimated usage and sales, among other factors.

Property, plant and equipment: Property, plant and equipment are stated at cost, net of accumulated depreciation. Costs incurred to develop internal-use computer software during the application development stage generally are capitalized. Costs of enhancements to internal-use computer software are capitalized, provided that these enhancements result in additional functionality. Other additions and those improvements which increase the capacity or lengthen the useful lives of the assets are also capitalized. Composite useful lives for categories of property, plant and equipment, which are depreciated on a straight-line basis, are as follows: buildings — 30 years; machinery and equipment — 3 to 15 years; computer equipment and software — 3 to 510 years. Leasehold improvements are depreciated over the lesser of the useful lives of the leasehold improvements or the remaining lease term. Repairs and maintenance costs are expensed as incurred.
Goodwill and other intangible assets: Goodwill and other indefinite-lived intangible assets are not amortized but are tested for impairment annually during the fourth quarter or more frequently if events or changes in circumstances indicate that an impairment may exist. Impairment losses, if any, are included in income from operations. The goodwill impairment test is applied to each of our reporting units. For purposes of this assessment, a reporting unit is an operating segment, or a business one level below an operating segment (also known as a component) if discrete financial information is prepared for that business and regularly reviewed by segment management. However, separate components are aggregated as a single reporting unit if they have similar economic characteristics.
In performing the goodwill impairment test, we may assess qualitative factors to determine whether it is more likely than not that the fair value of a reporting unit is less than its carrying value. Qualitative factors may include, but are not limited to, macroeconomic conditions, industry conditions, the competitive environment, changes in the market for our products and services, regulatory and political developments, and entity specific factors such as
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strategies and financial performance. If, after completing the qualitative assessment, we determine it is more likely than not that the fair value of a reporting unit is less than its carrying value, we proceed to a two-step quantitative impairment
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test, described below. Alternatively, we may elect to bypass the qualitative assessment and perform the two-step quantitative impairment test. The first step of the two-stepUnder a quantitative impairment test, is towe compare the fair value of a reporting unit to its carrying value. If the reporting unit fair value exceeds the carrying value, there is no impairment. If the reporting unit carrying value exceeds the fair value, we would perform the second step of the goodwill impairment test, in which we would measure the amount ofrecognize an impairment loss if any, based on the amount by which the carrying value of goodwill exceeds its implied fair value. The implied fair value of goodwill is determined by deducting the fair value of a reporting unit's identifiable assets and liabilities from the fair value of the reporting unit as a whole, as if that reporting unit had just been acquired and theexceeds its fair value of the individual assets acquired and liabilities assumed were being determined initially.value. We did not record a goodwill impairment charge for the year ended December 31, 2020.2022.
Our intangible assets consist of customer relationships, intellectual property, distribution rights, in-process research and development ("IPR&D"), trade names and non-competition agreements. We define IPR&D as the value of technology acquired for which the related projects have substance and are incomplete. IPR&D acquired in a business acquisition is recognized at fair value and is required be capitalized as an indefinite-lived intangible asset until completion of the IPR&D project or upon abandonment. Upon completion of the development project (generally when regulatory approval to market the product that utilizes the technology is obtained), an impairment assessment is performed prior to amortizing the asset over its estimated useful life. If the IPR&D projects are abandoned, the related IPR&D assets would be written off. 
We test our indefinite-lived intangible assets for impairment annually, or more frequently if events or changes in circumstances indicate that an impairment may have occurred. Similar to the goodwill impairment test process, we may elect to perform a qualitative assessment. If, after completing the qualitative assessment, we determine it is more likely than not that the fair value of the indefinite-lived intangible asset is greater than its carrying amount, the asset is not impaired. If we conclude it is more likely than not that the fair value of the indefinite-lived intangible asset is less than the carrying value, we then proceed to a quantitative impairment test, which consists of a comparison of the fair value of the intangible asset to its carrying amount.
Intangible assets that do not have indefinite lives, consisting of intellectual property, customer relationships, distribution rights, certain trade names and non-competition agreements, are amortized over their estimated useful lives, which are as follows: intellectual property, 5 to 20 years; customer relationships, 8 to 27 years; distribution rights, 10 years; trade names, 510 to 30 years; non-competition agreements, 3 tonon-compete agreement, 6 years. The weighted average remaining amortization period with respect to our intangible assets is approximately 15 years. We periodically evaluate the reasonableness of the useful lives of these assets.
For the year ended December 31, 2020, intangible asset amortization expense of $84.4 million is included within costs of good sold. For the year ended December 31, 2019 and December 31, 2018, we reclassified intangible asset amortization expense of $82.6 million and $81.6 million, respectively, from selling, general and administrative expenses to cost of goods sold for comparability.
Long-lived assets: We assess the remaining useful life and recoverability of long-lived assets whenever events or changes in circumstances indicate the carrying value of an asset may not be recoverable. The assessment is based on various analyses, including undiscounted cash flow and profitability projections that incorporate, as applicable, the impact of the asset on the existing business. Therefore, the evaluation involves significant management judgment. Any impairment loss, if indicated, is measured as the amount by which the carrying amount of the asset exceeds the estimated fair value of the asset.
Foreign currency translation: Assets and liabilities of subsidiaries with non-United States dollar denominated functional currencies are translated into United States dollars at the rates of exchange at the balance sheet date; income and expenses are translated at the average rates of exchange prevailing during the year. The translation adjustments are reported as a component of accumulated other comprehensive loss.
Derivative financial instruments: We use derivative financial instruments primarily for purposes of hedging exposures to fluctuations in foreign currency exchange rates. All instruments are entered into for other than trading purposes. All derivatives are recognized on the balance sheet at fair value. Changes in the fair value of derivatives are recorded in the consolidated statement of comprehensive income as other comprehensive income (loss), if the instrument is designated as part of a hedge transaction. Gains or losses on derivative instruments reported in other comprehensive income (loss) are reclassified to the consolidated statement of income in the period in which
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earnings are affected by the underlying hedged item. Gains or losses on derivative instruments representing hedge ineffectiveness or hedge components excluded from the assessment of effectiveness, if any, are recognized in the consolidated statement of income for the period in which such gains and losses occur. If the hedging relationship ceases to be highly effective or it becomes probable that an expected transaction will no longer occur, gains or losses on the derivative instrument are recorded in the consolidated statement of income for the period in which either such event occurs. For non-designated derivatives, gains and losses are reported as selling, general and administrative expenses in the consolidated statement of income. Cash flows from derivatives are recognized in the consolidated statements of cash flows in a manner consistent with the recognition of the underlying transactions.
Share-based compensation: We estimate the fair value of share-based awards on the date of grant using an option pricing model. The value of the portion of the award that is ultimately expected to vest, which is derived, in
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part, following consideration of estimated forfeitures, is recognized as expense over the requisite service periods. Share-based compensation expense related to stock options is measured using a Black-Scholes option pricing model that takes into account subjective and complex assumptions with respect to the expected life of the options, volatility, risk-free interest rate and expected dividend yield. The expected life of options granted is derived from the vesting period of the award, as well as historical exercise behavior, and represents the period of time that options granted are expected to be outstanding. Expected volatility is based on a blend of historical volatility and implied volatility derived from publicly traded options to purchase our common stock, which we believe is more reflective of market conditions and a better indicator of expected volatility than would be the case if we only used historical volatility. The risk-free interest rate is the implied yield currently available on United States (or "U.S.") Treasury zero-coupon issues with a remaining term equal to the expected life of the option. Forfeitures are estimated at the time of grant based on management’s expectations regarding the extent to which awards ultimately will vest and are adjusted for actual forfeitures when they occur.
Income taxes: The provision for income taxes is determined using the asset and liability approach of accounting for income taxes. Under this approach, deferred tax assets and liabilities are recognized to reflect the future tax consequences attributable to the differences between the financial statement carrying amounts of existing assets and liabilities and their tax bases, and to reflect operating loss and tax credit carryforwards. The provision for income taxes represents income taxes paid or payable for the current year plus the change in deferred taxes during the year. Provision has been made for income taxes on unremitted earnings of subsidiaries and affiliates, except to the extent that such earnings are deemed to be permanently reinvested.
Significant judgment is required in determining income tax provisions and in evaluating tax positions. We establish additional provisions for income taxes when, despite the belief that tax positions are supportable, there remain certain positions that do not meet the minimum probability threshold, which is a tax position that is more likely than not to be sustained upon examination by the applicable taxing authority. In the normal course of business, we are examined by various federal, state and non-U.S. tax authorities. We regularly assess the potential outcomes of these examinations and any future examinations for the current or prior years in determining the adequacy of itsour provision for income taxes. Interest accrued with respect to unrecognized tax benefits and income tax related penalties are both included in taxes on income from continuing operations. We periodically assess the likelihood and amount of potential adjustments and adjustsadjust the income tax provision, the current tax liability and deferred taxes in the period in which the facts that give rise to an adjustment become known.
Pensions and other postretirement benefits: We provide a range of benefits to eligible employees and retired employees, including benefits available pursuant to pension and postretirement healthcare benefits plans. We record annual amounts relating to these plans based on calculations which include various actuarial assumptions such as discount rates, expected rates of return on plan assets, compensation increases, turnover rates and healthcare cost trend rates. We review our actuarial assumptions on an annual basis and makesmake modifications to the assumptions based on current rates and trends when appropriate. The effect of the modifications is generally amortized over future periods.
Restructuring costs: Restructuring costs, which include termination benefits, facility closure costs, contract termination costs and other restructuring costs, are recorded at estimated fair value. Other restructuring costs may include facility closure, employee relocation, equipment relocation and outplacement costs. We primarily recognize employee termination benefits when payment becomes probable and reasonably estimable because they are provided under an ongoing benefit arrangement and are based on existing plans, historical experiencesexperience and negotiated settlements of prior plans. Termination benefits provided under one-time termination benefits arrangements, if any, are recognized upon communication to the employee. We recognize charges ratably over the future service period if the employee is required to render service until termination. Key assumptions used in calculating
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theOther restructuring costs may include facility closure, employee relocation, equipment relocation and outplacement costs and are recognized in the terms of, and payments under, agreements to terminate certain contractual obligations and the timing of reductions in force.period they are incurred.
Contingent consideration related to business acquisitions: In connection with business acquisitions, we may be required to pay future consideration that is contingent upon the achievement of specified objectives such as receipt of regulatory approval, commercialization of a product or achievement of sales targets. As of the acquisition date,In a business combination, we record a contingent liability, as of the acquisition date, representing the estimated fair value of the contingent consideration that we expect to pay. We remeasure the fair value of our contingent consideration arrangements each reporting period and, based on new developments, recordsrecord changes in fair value until either the contingent consideration obligation is satisfied through payment upon the achievement of, or the obligation no longer exists due to the failure to achieve, the specified objectives. The change in the fair value is recorded in selling, general and administrative expenses in the consolidated statement of income. A contingent consideration payment is classified as a financing activity in the consolidated statement of cash flows to the extent it was recorded as a liability as of the acquisition date. Any additional amount paid in excess of the amount initially accrued is classified as an operating activity in the consolidated statement of cash flows.
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If the transaction is determined to be an asset acquisition rather than a business combination, a contingent consideration liability is recognized when the specified objective is deemed probable and is estimable.
Revenue recognition: We primarily generate revenue from the sale of medical devices including single use disposable devices and, to a lesser extent, reusable devices, instruments and capital equipment. Revenue is recognized when obligations under the terms of a contract with our customer are satisfied; this occurs upon the transfer of control of the products. Generally, transfer of control to the customer occurs at the point in time when our products are shipped from the manufacturing or distribution facility. For the OEM segment, most revenue is recognized over time because the OEM segment generates revenue from the sale of custom products that have no alternative use and we have an enforceable right to payment to the extent that performance has been completed. We market and sell products through our direct sales force and distributors to customers within the following end markets: (1) hospitals and healthcare providers; (2) other medical device manufacturers; and (3) home care providers, which represented 88%, 9%10% and 3%2% of our consolidated net revenues, respectively, for the year ended December 31, 2020.2022. Revenue is measured as the amount of consideration we expect to receive in exchange for transferring goods. With respect to the custom products sold in the OEM segment, revenue is measured using the units produced output method. Payment is generally due 30 days from the date of invoice.
We have made the following revenue accounting policy elections and elected to use certain practical expedients: (1) we account for amounts collected from customers for sales and other taxes, net of related amounts remitted to tax authorities; (2) we do not adjust the promised amount of consideration for the effects of a significant financing component because, at contract inception, we expect the period between the time when we transfer a promised good or service to the customer and the time when the customer pays for that good or service will be one year or less; (3) we expense costs to obtain a contract as they are incurred if the expected period of benefit, and therefore the amortization period, is one year or less; (4) we account for shipping and handling activities that occur after control transfers to the customer as a fulfillment cost rather than an additional promised service; (5) we classify shipping and handling costs within cost of goods sold; and (6) with respect to the OEM segment, we have applied the practical expedient to exclude disclosure of remaining performance obligations as the contracts typically have a term of one year or less.
The amount of consideration we receive and revenue we recognize varies as a result of changes in customer sales incentives, including discounts and rebates, and returns offered to customers. The estimate of revenue is adjusted upon the earlier of the following events: (i) the most likely amount of consideration expected to be received changes or (ii) the consideration becomes fixed. Our policy is to accept returns only in cases in which the product is defective and covered under our standard warranty provisions. When we give customers the right to return products, we estimate the expected returns based on an analysis of historical experience. The liability for returns and allowances was $14.6$17.9 million and $7.2$15.2 million as of December 31, 20202022 and 2019,2021, respectively. In estimating customer rebates, we consider the lag time between the point of sale and the payment of the customer’s rebate claim, customer-specific trend analyses, contractual commitments, including stated rebate rates, historical experience with respect to specific customers (as we have a history of providing similar rebates on similar products to similar customers) and other relevant information. The reserve for customer incentive programs, including customer rebates, was $28.5$29.0 million and $21.6$26.4 million at December 31, 20202022 and 2019,2021, respectively. We expect the amounts subject to the reserve as of December 31, 20202022 to be paid within 90 days subsequent to period-end.
Leases: On January 1, 2019, we adopted an amendment to the guidance on leases using a modified retrospective transition approach. We have made an accounting policy election not to apply the lease accounting recognition provisions to short term leases (leases with a lease term of 12 months or less that do not include an option to purchase the underlying asset that the lessee is reasonably certain to exercise); instead, we will recognize
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the lease payments for short term leases on a straight-line basis over the lease term. We have made as a practical expedient, an accounting policy election to not separate lease and non-lease components and instead will account for each separate lease component and the non-lease components associated with that lease component as a single lease component.

Note 2 — Recently issued accounting standards
In June 2016, the FASB issued new guidance that changes the methodology to be used to measure credit losses for certain financial instruments and financial assets, including trade receivables. Under current guidance, an entity reflects credit losses on financial assets measured on an amortized cost basis only when it is probable that losses have been incurred, generally considering only past events and current conditions in determining incurred loss. The new guidance requires the recognition of an allowance that reflects the current estimate of credit losses expected to be incurred over the life of the financial asset, based not only on historical experience and current conditions, but also on reasonable forecasts. The main objective of the new guidance is to provide financial statement users with more useful information in making decisions about the expected credit losses on financial instruments and other commitments to extend credit held by a reporting entity at each reporting date. We adopted the new standard on January 1, 2020 using a modified retrospective transition approach by recognizing a cumulative-effect adjustment of $0.8 million to reduce our opening balance of retained earnings as of the adoption date. Prior period amounts have not been adjusted and continue to reflect our historical accounting.
In December 2019, the FASB issued new guidance that simplifies various aspects of accounting for income taxes including those related to the step-up in the tax basis of goodwill, intraperiod tax allocations and the interim period effects of changes in tax laws or rates. The new guidance is effective for fiscal years beginning after December 15, 2020, including interim periods within those fiscal years. Early adoption is permitted. The majority of the modifications under the new guidance will be applied on a modified retrospective basis through a cumulative-effect adjustment to retained earnings on January 1, 2021. The adoption of the guidance did not have a material impact on the consolidated financial statements.
In January 2017, the FASB issued guidance to simplify the quantitative test for goodwill impairment. Under current guidance, if a reporting unit’s carrying value exceeds its fair value, the entity must determine the implied value of goodwill. This determination is made by deducting the fair value of a reporting unit’s identifiable assets and liabilities from the fair value of the reporting unit as a whole as if the reporting unit had just been acquired. Under the new guidance, a determination of the implied value of goodwill will no longer be required; a goodwill impairment will be equal to the amount by which a reporting unit’s carrying value exceeds its fair value, not to exceed the carrying amount of goodwill. We adopted this guidance on January 1, 2020 and will apply it, as applicable, to impairment testing we perform in 2020 and future years. The adoption of the guidance did not have an impact on the consolidated financial statements.
From time to time, new accounting guidance issued by the FASB or other standard setting bodies is adopted as of the specified effective date or, when permitted by the guidance and as determined by us, as of an earlier date. We have assessed recently issued guidance that is not yet effective except as noted above, and believe the new guidance that we have assessed will not have a material impact on our results of operations, cash flows or financial position.

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Note 3 - Net revenues
The following table disaggregates revenue by global product category for the year ended December 31, 2020, 20192022, 2021 and 2018.2020.
Year Ended December 31
202020192018
Vascular access$657,703 $600,874 $575,327 
Anesthesia302,293 338,413 349,370 
Interventional382,435 427,563 395,423 
Surgical317,200 370,074 358,707 
Interventional urology290,022 290,449 196,735 
OEM220,246 220,717 205,976 
Other (1)
367,257 347,272 366,845 
Net revenues (2)
$2,537,156 $2,595,362 $2,448,383 
Year Ended December 31,
202220212020
Vascular access$683,612 $700,240 $657,703 
Anesthesia388,890 380,140 302,293 
Interventional445,018 427,500 382,435 
Surgical392,917 377,756 317,200 
Interventional urology322,832 341,661 290,022 
OEM272,624 245,681 220,246 
Other (1)
285,148 336,585 367,257 
Net revenues (2)
$2,791,041 $2,809,563 $2,537,156 
(1) Revenues in the "Other" category in the table above includeIncludes revenues generated from sales of our respiratory and urology products (other than interventional urology products). Certain product lines within the respiratory product category were sold during 2021. See Note 4 for additional information related to the Respiratory business divestiture.
(2) The product categories listed above are presented on a global basis, while each of our reportable segments other than the OEM reportable segment are defined based on the geographic location of its operations; the OEM reportable segment operates globally. Each of the geographically based reportable segments includeincludes net revenues from each of the non-OEM product categories listed above.

Note 4 — Acquisitions and Divestitures
2020 AcquisitionsDivestiture
On February 18, 2020,September 27, 2022, the second day of the fourth quarter, we acquired IWG High Performance Conductors,completed the acquisition of Standard Bariatrics, Inc. (HPC)(“Standard Bariatrics”), a privately-held original equipment manufacturer of minimally invasive medical products and high performance conductors, for an initial purchase price of $260.0 million. The acquisition complements our OEM product portfolio. For the year ended December 31, 2020, we recorded post acquisition revenue and an operating loss of $27.1 million and $0.2 million, respectively, related to HPC within our OEM operating segment. Goodwill arising from the HPC acquisition is 0t tax deductible and represents costs synergies, revenue growth attributable to anticipated increased market penetration from acquired products and the establishment of new customer relationships.
On December 28, 2020, we acquired Z-Medica, LLC ("Z-Medica"), a privately held medical device company that manufactures and sells hemostatic (hemorrhage control) products, marketed under the QuikClot, Combat Gauze and QuickClot Control+ brand names, to complementcommercialized a powered stapling technology for bariatric surgery that complements our anesthesiasurgical product portfolio. The fair value of consideration transferred was $211.8 million, which included cash payments of $173.0 million and $38.8 million in estimated fair value of contingent consideration. The contingent consideration liability represents the estimated fair value of our obligations, under the acquisition included an initial cash purchase price of $500.0 million, with the potentialagreement, to make an additional paymentthree milestone payments up to $25$130 million upon the achievement ofin aggregate if certain commercial milestones.milestones are met. The milestone payments are based on net sales growth over the three-year period following the closing of the transaction. The fair value of the contingent consideration was estimated using a Monte Carlo valuation approach. See Note 12 for additional information related toon the fair value measurement of the contingent consideration. The goodwill arising fromacquisition was financed using borrowings under our revolving credit facility and cash on hand.
The following table presents the Z-Medica acquisition is 0t tax deductible and primarily represents synergies currently expected to be realized from the integrationfair value of the Z-Medica business in additionassets acquired and liabilities assumed with respect to the benefit we expect to realize from the establishment of new customer relationships and the development of technology resulting from the operation of the Z-Medica business.Standard Bariatrics acquisition:
For the year ended December 31, 2020, the Company incurred $6.6 million in transaction expenses associated with the HPC and Z-Medica acquisitions, which are included in selling, general and administrative expenses in the consolidated statement of income.
(Dollars in thousands)
Assets
Current assets$8,028 
Property, plant and equipment3,342 
Intangible assets154,450 
Goodwill71,420 
Other assets2,122 
Total assets acquired239,362 
Less:
Current liabilities2,661 
Other liabilities24,896 
Liabilities assumed27,557 
Net assets acquired$211,805 

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The following table presentsgoodwill resulting from the fair valueStandard Bariatrics acquisition primarily reflects synergies currently expected to be realized from the integration of the acquired assetsbusiness and liabilities assumed with respect to each acquisition:
HPCZ-Medica
Assets
Current assets$10,785 $16,649 
Property, plant and equipment10,457 4,492 
Intangible assets179,000 332,000 
Goodwill107,127 187,939 
Other assets270 153 
Total assets acquired307,639 541,233 
Less:
Current liabilities1,568 5,068 
Deferred tax liabilities43,449 35,225 
Noncurrent liability for uncertain tax positions1,945 
Other liabilities91 
Liabilities assumed46,962 40,384 
Net assets acquired$260,677 $500,849 

We are continuing to evaluate the fair value of the acquired assets and liabilities assumed in connection with the Z-Medica acquisition and further adjustments may be necessary during the measurement period.is not tax deductible.
The following table sets forth the components of identifiable intangible assets acquired and the ranges of the useful lives as of the date of eachthe Standard Bariatrics acquisition:
HPCZ-MedicaStandard Bariatrics
Fair valueUseful life (years)Fair valueUseful life (years)Fair valueUseful life (years)
Intellectual propertyIntellectual property$40,000 20$86,500 13 - 16Intellectual property$128,300 15
Trade namesTrade names— 47,500 25Trade names22,500 25
Customer relationshipsCustomer relationships139,000 20198,000 26Customer relationships3,650 11

For the year ended December 31, 2022, we incurred $1.3 million in transaction expenses associated with the Standard Bariatrics acquisition, which are included in selling, general and administrative expenses in the consolidated statement of income. Pro forma information for the acquisitions completed in 2020Standard Bariatrics acquisition is not presented as the operations of the acquired businessesStandard Bariatrics are not deemed to be significant to our overall operations.
2019 Asset Acquisition
On June 13, 2022, we acquired a privately-owned catheter company for an initial cash payment of $22.8 million. Under the terms of the acquisition agreement, we may become obligated to make additional cash payments up to $26.2 million if certain commercial and revenue goals are met. The acquisition, which complements our interventional product portfolio, principally consisted of a proprietary catheter design and other related intellectual property, being amortized over a useful life of 15 years.
Divestiture
On February 4, 2019,May 15, 2021, we sold substantially allentered into a definitive agreement to sell certain product lines within our global respiratory product portfolio (the "Divested respiratory business") to Medline Industries, Inc. (“Medline”) for consideration of the assets related$286.0 million, reduced by $12.0 million in working capital not transferring to our vein catheter reprocessingMedline, which is subject to customary post close adjustments (the "Respiratory business for $12.6 million. We recognized a $2.7 million pre-tax gain on the sale of assets, which represents the excess of the $9.7 million fair value of consideration received over the carrying value of the assets sold.divestiture"). In connection with the sale,Respiratory business divestiture, we also entered into several ancillary agreements with Medline to help facilitate the purchasertransfer of the assets issuedbusiness, which provide for transition support, quality, supply and manufacturing services, including a secured promissory notemanufacturing and supply transition agreement (the "MSTA").
On June 28, 2021, we completed the initial phase of the Respiratory business divestiture, pursuant to us in the principal amountwhich we received cash proceeds of $10.5$259.0 million. The purchaser's obligations under the notes are secured by a lien on substantially allsecond phase of the purchaser's assets. The purchaserRespiratory business divestiture will occur once we transfer certain additional manufacturing assets to Medline. Our receipt of $15.0 million in additional cash proceeds is obligatedcontingent upon the transfer of these manufacturing assets and is expected to repayoccur prior to the principal amountend of 2023. We plan to recognize the contingent consideration, and any gain on sale resulting from the second phase of the promissory note in annual installments of $2.1 million ondivestiture, when it becomes realizable.
Net revenues attributable to our divested respiratory business recognized prior to the Respiratory business divestiture are included within each of our geographic segments and were $60.7 million and $138.5 million for the first five anniversaries of the date of sale. On the date of sale, the fair value of the promissory note was $7.6 million, which we calculated by applying a discount rate determined after taking into account the creditworthiness of the purchaser. As ofyears ended December 31, 2021 and 2020, we had $5.6 millionrespectively. Net revenues attributed to services provided to Medline in receivables related toaccordance with the promissory note, ofMSTA, which $4.7are presented within our Americas reporting segment, were $79.1 million and $0.9$51.1 million are included in accounts receivable, netfor the years ended December 31, 2022, and other assets, respectively, within the consolidated balance sheet.2021, respectively.
Supplemental cash flow information
Year Ended December 31,
202220212020
Non cash investing and financing activities of continuing operations:
Acquisition of businesses$43,168 $— $— 

Note 5 — Restructuring and impairment charges
During the second quarter of 2020, we committed to a workforce reduction (the "2020 Workforce reduction plan") designed to improve profitability and reduce cost primarily by streamlining certain sales and marketing functions in our EMEA segment and certain manufacturing operations in our OEM segment. The workforce reduction was initiated to further align the business with our high growth strategic objectives. The plan was
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substantially completed atNote 5 — Restructuring and impairment charges
2022 restructuring plan
On November 15, 2022, we initiated a strategic restructuring plan designed to improve operating performance and position the end of 2020 and we expect futureorganization to deliver long-term durable growth by creating efficiencies that align with our high growth strategic objectives (the “2022 restructuring expenses associated with the program, if any, to be nominal.
We have ongoing restructuring programs related toplan”). The plan primarily involves the relocation of certain manufacturing operations to existing lower-cost locations in addition to the streamlining of various business functions across the organization and related workforce reductions (referredreductions. These actions are expected to as our 2019, 2018 and 2014 Footprint realignment plans). be substantially completed during 2023.
The following tables providetable provides a summary of ourthe cost estimates and other informationby major type of expense associated with these ongoing plans:the 2022 restructuring plan:
2019 Footprint realignment plan (3)
2018 Footprint realignment plan (4)
2014 Footprint realignment plan (5)
Program expense estimates:(Dollars in millions)
Termination benefits$16 to $18$60 to $70$13 to $13
Other costs (1)
2 to 23 to 41 to 2
Restructuring charges18 to 2063 to 7414 to 15
Restructuring related charges (2)
38 to 4340 to 5938 to 40
Total restructuring and restructuring related charges$56 to $63$103 to $133$52 to $55
Other program estimates:
Expected cash outlays$50 to $57$99 to $127$42 to $46
Expected capital expenditures$28 to $33$19 to $23$26 to $27
Other program information:
Period initiatedFebruary 2019May 2018April 2014
Estimated period of substantial completion202220222022
Aggregate restructuring charges$15.3$60.0$13.6
Restructuring related charges incurred:
For year ended December 31, 2020$14.5$9.5$3.8
Aggregate restructuring related charges$21.1$16.7$36.0

Total estimated amount expected to be incurred
Plan expense estimates:(Dollars in millions)
Termination benefits$18 million to $22 million
Other costs (1)
$1 million to $1 million
Restructuring Charges$19 million to $23 million
Restructuring related charges (2)
$20 million to $25 million
Total restructuring and restructuring related charges$39 million to $48 million
(1)Includes facility closure employee relocation, equipment relocation and outplacement costs.
(2)Restructuring related charges represent costs that are directly related to the programsprogram and principally constitutecomprise costs to transfer manufacturing operations to the existing lower-cost locations, project management costs and accelerated depreciation. The 2018 Footprint realignment plan also includes an $8.1 million non cash tax related charge arising from establishing a charge associated with our exit from the facilities thatvaluation allowance against a local deferred tax asset, which is no longer expected to be imposed byutilized as a result of the taxing authority in the affected jurisdiction.transfer. Excluding this tax charge, substantially allthe majority of thesethe restructuring related charges are expected to be recognized within cost of goods sold.
(3)In 2020, we refined the disclosed ranges for eachWe estimate that $26 million to $32 million of the components of the program expenserestructuring and other program estimates in consideration of the progress made to date as well as the actions remaining. The refinements resulted in a decrease in the high end of the disclosed ranges compared to our prior estimates.
(4)In 2020, we accelerated the timing of substantial completion from our prior estimate of 2024 to take advantage of an opportunity we identified to accelerate the recognition of estimated savings.
(5)In 2020, we extended our timeline of certain development and qualification activities which resulted in a delay in the anticipated period of substantial completion from our prior estimate of 2021. The shift in timing also resulted in an increase in the total program cost estimate, primarily restructuring related charges and relatedwill result in cash outlays, comparedmost of which are expected to prior estimates. We also refined the disclosed range ofbe made in 2023. Additionally, we expect to incur approximately $2 million in aggregate capital expenditures under the plan, most of which is expected to be incurred during 2023.
For the year ended December 31, 2022, we incurred $10.1 million in considerationrestructuring related charges, which were recognized in cost of goods sold and taxes on income from continuing operations.
Respiratory divestiture plan
During 2021 and in connection with the Respiratory business divestiture, we committed to a restructuring plan designed to separate the manufacturing operations to be transferred to Medline from those that will remain with Teleflex, which includes related workforce reductions (the “Respiratory divestiture plan”). The plan includes expanding certain of our existing locations to accommodate the transfer of capacity from the sites being transferred to Medline and replicating the manufacturing processes at alternate existing locations. We expect this plan will be substantially completed by the end of 2023. The following table provides a summary of our cost estimates by major type of expense associated with the Respiratory divestiture plan:
Total estimated amount expected to be incurred
Plan expense estimates:(Dollars in millions)
Restructuring charges (1)
$5 million to $8 million
Restructuring related charges (2)
$19 million to $22 million
Total restructuring and restructuring related charges$24 million to $30 million
(1) Substantially all of the progress madecharges consist of employee termination benefit costs.
(2)Consist of charges that are directly related to date as well as actions remaining.the Respiratory divestiture plan and principally constitute costs to transfer manufacturing operations to other locations and project management costs. Substantially all of the charges are expected to be recognized within costs of goods sold.
We expect substantially all of the restructuring and restructuring related charges will result in future cash outlays. Additionally, we expect to incur $22 million to $28 million in aggregate capital expenditures under the plan.
For the years ended December 31, 2022 and 2021, we incurred $8.9 million and $3.3 million, respectively, in pre-tax restructuring related charges, all of which were recognized in cost of goods sold.
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TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

As of December 31, 2022, we have incurred net aggregate restructuring expenses related to the Respiratory divestiture plan of $3.3 million. Additionally, as of December 31, 2022, we have incurred net aggregate restructuring related charges in connection with the Respiratory divestiture plan of $12.2 million, which were primarily included in cost of goods sold.
2019 Footprint realignment plan
In February 2019, we initiated a restructuring plan primarily involving the relocation of certain manufacturing operations to existing lower-cost locations and related workforce reductions (the “2019 Footprint realignment plan"). The plan is substantially complete and as a result, we expect future restructuring expenses associated with the plan, if any, to be immaterial.
2018 Footprint realignment plan
In May 2018, we initiated a restructuring plan involving the relocation of certain European manufacturing operations to existing lower-cost locations, the outsourcing of certain European distribution operations and related workforce reductions (the "2018 Footprint realignment plan"). The plan is substantially complete and as a result, we expect future restructuring expenses associated with the plan, if any, to be immaterial.
2014 Footprint realignment plan
In April 2014, we initiated a restructuring plan involving the consolidation of operations and a related reduction in workforce at certain facilities, and the relocation of manufacturing operations from certain higher-cost locations to existing lower-cost locations (the "2014 Footprint realignment plan"). The plan is substantially complete and as a result, we expect future restructuring expenses associated with the plan, if any, to be immaterial.
The following table summarizes the restructuring reserve activity related to our 2022 restructuring plan, Respiratory divestiture plan as well as the 2019 2018 and 20142018 Footprint realignment plans:
2019 Footprint realignment plan2018 Footprint realignment plan2014 Footprint realignment plan2022 restructuring planRespiratory divestiture plan2019 Footprint realignment plan2018 Footprint realignment plan
Balance at December 31, 2018$$48,474 $3,936 
Subsequent accruals13,753 (939)313 
Cash payments(1,602)(3,628)(580)
Foreign currency translation(281)367 
Balance at December 31, 201911,870 44,274 3,669 
Balance at December 31, 2020 (1)
Balance at December 31, 2020 (1)
$— $— $8,054 $50,081 
Subsequent accrualsSubsequent accruals1,542 5,948 606 Subsequent accruals— 2,694 253 2,476 
Cash paymentsCash payments(5,532)(4,281)(682)Cash payments— (7)(4,982)(4,813)
Foreign currency translation and otherForeign currency translation and other174 4,140 Foreign currency translation and other— (86)(19)(3,679)
Balance at December 31, 2020 (1)
$8,054 $50,081 $3,593 
Balance at December 31, 2021 (1)
Balance at December 31, 2021 (1)
— 2,601 3,306 44,065 
Subsequent accrualsSubsequent accruals15,523 578 (987)2,076 
Cash paymentsCash payments(978)(149)(874)(24,310)
Foreign currency translation and otherForeign currency translation and other315 19 — (3,292)
Balance at December 31, 2022 (1)
Balance at December 31, 2022 (1)
$14,860 $3,049 $1,445 $18,539 
(1)The restructuring reserves as of December 31, 2020 , 20192022, 2021 and 20182020 consisted mainly of accruals related to termination benefits. Most of the Other costs (facility closure, employee relocation, equipment relocation and outplacement costs) were expensed and paid in the same period.
The restructuring and impairment charges recognized for the years ended December 31, 2020, 2019,2022, 2021, and 20182020 consisted of the following:
20202022
Termination benefits
Other Costs (1)
TotalTermination benefits
Other Costs (1)
Total
2020 Workforce reduction plan$8,494 $353 $8,847 
2022 Restructuring plan2022 Restructuring plan$15,465 $58 $15,523 
Respiratory divestiture planRespiratory divestiture plan504 74 578 
2019 Footprint realignment plan2019 Footprint realignment plan647 895 1,542 2019 Footprint realignment plan(1,120)133 (987)
2018 Footprint realignment plan2018 Footprint realignment plan5,565 383 5,948 2018 Footprint realignment plan1,230 846 2,076 
Other restructuring programs (2)
Other restructuring programs (2)
(72)838 766 
Other restructuring programs (2)
1,306 306 1,612 
Total restructuring chargesTotal restructuring charges14,634 2,469 17,103 Total restructuring charges17,385 1,417 18,802 
Asset impairment chargesAsset impairment charges21,388 21,388 Asset impairment charges— 1,497 1,497 
Total restructuring and impairment chargesTotal restructuring and impairment charges$14,634 $23,857 $38,491 Total restructuring and impairment charges$17,385 $2,914 $20,299 
F-18

TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

2019
Termination benefits
Other Costs (1)
Total
2019 Footprint realignment plan$13,683 $70 $13,753 
2018 Footprint realignment plan(1,787)848 (939)
Other restructuring programs (3)
787 1,638 2,425 
Total restructuring charges12,683 2,556 15,239 
Asset impairment charges6,966 6,966 
Total restructuring and impairment charges$12,683 $9,522 $22,205 

2021
Termination benefits
Other Costs (1)
Total
Respiratory divestiture plan$2,687 $$2,694 
2021 Restructuring plan7,280 77 7,357 
2019 Footprint realignment plan(111)364 253 
2018 Footprint realignment plan2,335 141 2,476 
Other restructuring programs (3)
(429)2,648 2,219 
Total restructuring charges11,762 3,237 14,999 
Asset impairment charges— 6,739 6,739 
Total restructuring and impairment charges$11,762 $9,976 $21,738 
20182020
Termination benefits
Other Costs (1)
TotalTermination benefits
Other Costs (1)
Total
2020 Workforce reduction plan2020 Workforce reduction plan$8,494 $353 $8,847 
2019 Footprint realignment plan2019 Footprint realignment plan647 895 1,542 
2018 Footprint realignment plan2018 Footprint realignment plan$53,992 $1,001 $54,993 2018 Footprint realignment plan5,565 383 5,948 
Other restructuring programs (4)
Other restructuring programs (4)
3,820 1,307 5,127 
Other restructuring programs (4)
(72)838 766 
Total restructuring chargesTotal restructuring charges57,812 2,308 60,120 Total restructuring charges14,634 2,469 17,103 
Asset impairment chargesAsset impairment charges19,110 19,110 Asset impairment charges— 21,388 21,388 
Total restructuring and impairment chargesTotal restructuring and impairment charges$57,812 $21,418 $79,230 Total restructuring and impairment charges$14,634 $23,857 $38,491 
(1)Includes facility closure, contract termination and other exit costs.
(2)Includes activity primarily related to a restructuring plan initiated in the 2016 andfirst quarter of 2022 that is designed to relocate manufacturing operations at certain of our facilities, the 2014 Footprint realignment plans.plan and the 2020 Workforce reduction plan, a program initiated in the second quarter of 2020.
(3)Includes the program initiated during third quarter of 2019,2020 Workforce reduction plan and the 2017 Vascular Solutions integration program as well as the 2016 and 2014 Footprint realignment plans.plan.
(4)Includes activity primarily related to the 2016 Footprint realignment plan, which is substantially complete, and the 2014 Footprint realignment plan, as well as the 2017 Vascular Solutions integration program and the 2017 EMEA restructuring program.plans.
F-18

TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Impairment Charges
For the year ended December 31, 2022, we recorded impairment charges of $1.5 million related to our decision to abandon certain assets. For the year ended December 31, 2021, we recorded impairment charges of $6.7 million related to our decision to abandon intellectual property and other assets primarily associated with our respiratory product portfolio that was not transferred to Medline as part of the Respiratory business divestiture. For the year ended December 31, 2020, we recorded impairment charges of $21.4 million ($19.4 million after tax) related primarily to our decision to abandon intellectual property and other assets related to the Percuvance percutaneous surgical system product line. For the years ended December 31, 2019 and 2018 we recorded impairment charges of $7.0 million and $19.1 million, respectively, related to our decision to abandon certain intellectual property and other assets associated with our interventionalsurgical product portfolio.

Note 6 — Inventories
Inventories at December 31, 20202022 and 20192021 consist of the following:
20202019 20222021
Raw materialsRaw materials$132,370 $114,302 Raw materials$186,641 $146,433 
Work-in-processWork-in-process75,874 71,479 Work-in-process98,993 81,503 
Finished goodsFinished goods304,952 290,776 Finished goods292,873 249,707 
InventoriesInventories$513,196 $476,557 Inventories$578,507 $477,643 

F-19

TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Note 7 — Property, plant and equipment
The major classes of property, plant and equipment, at cost, at December 31, 20202022 and 20192021 were as follows: 
20202019
Land, buildings and leasehold improvements$272,637 $248,067 
Machinery and equipment496,664 443,612 
Computer equipment and software172,913 158,574 
Construction in progress84,336 63,991 
1,026,550 914,244 
Less: Accumulated depreciation(552,638)(483,525)
Property, plant and equipment, net$473,912 $430,719 

20222021
Land, buildings and leasehold improvements$272,578 $285,305 
Machinery and equipment462,447 475,040 
Computer equipment and software192,785 191,605 
Construction in progress76,077 49,782 
1,003,887 1,001,732 
Less: Accumulated depreciation(556,682)(557,974)
Property, plant and equipment, net$447,205 $443,758 

Note 8 — Goodwill and other intangible assets
Changes in the carrying amount of goodwill, by reportable operating segment, for the years ended December 31, 20202022 and 20192021 were as follows:
 AmericasEMEAAsiaOEMTotal
Balance as of December 31, 2018
Goodwill$1,881,662 $480,615 $211,547 $4,883 $2,578,707 
Accumulated impairment losses(332,128)(332,128)
1,549,534 480,615 211,547 4,883 2,246,579 
Goodwill related to acquisitions439 189 1,205 1,833 
Translation and other adjustments952 (5,032)973 (3,107)
Balance as of December 31, 20191,550,925 475,772 213,725 4,883 2,245,305 
Goodwill related to acquisitions149,877 22,364 15,698 107,127 295,066 
Translation and other adjustments(520)38,092 8,023 45,595 
Balance as of December 31, 2020$1,700,282 $536,228 $237,446 $112,010 $2,585,966 
F-19

TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

 AmericasEMEAAsiaOEMTotal
Balance as of December 31, 2020
Goodwill$2,032,410 $536,228 $237,446 $112,010 $2,918,094 
Accumulated impairment losses(332,128)— — — (332,128)
1,700,282 536,228 237,446 112,010 2,585,966 
Goodwill disposed(21,802)(7,537)(6,406)— (35,745)
Goodwill related to acquisitions(1,560)(232)(163)— (1,955)
Translation and other adjustments(696)(36,310)(7,058)— (44,064)
Balance as of December 31, 20211,676,224 492,149 223,819 112,010 2,504,202 
Goodwill related to acquisitions53,970 7,281 10,169 — 71,420 
Translation and other adjustments899 (30,906)(8,885)— (38,892)
Balance as of December 31, 2022$1,731,093 $468,524 $225,103 $112,010 $2,536,730 
Intangible assets at December 31, 20202022 and 20192021 consisted of the following:
Gross Carrying AmountAccumulated Amortization Gross Carrying AmountAccumulated Amortization
2020201920202019 2022202120222021
Customer relationshipsCustomer relationships$1,377,943 $1,021,852 $(425,692)$(367,585)Customer relationships$1,328,539 $1,328,611 $(497,335)$(441,059)
In-process research and developmentIn-process research and development29,627 27,940 — — In-process research and development27,075 28,158 — — 
Intellectual propertyIntellectual property1,458,924 1,351,990 (479,612)(402,340)Intellectual property1,599,355 1,440,643 (646,643)(560,740)
Distribution rightsDistribution rights23,866 23,369 (20,280)(18,859)Distribution rights23,115 23,434 (21,090)(20,630)
Trade namesTrade names619,847 563,315 (65,955)(50,718)Trade names564,023 549,269 (71,128)(59,249)
Non-compete agreementsNon-compete agreements24,592 22,618 (23,514)(15,297)Non-compete agreements21,429 22,783 (21,175)(22,153)
$3,534,799 $3,011,084 $(1,015,053)$(854,799) $3,563,536 $3,392,898 $(1,257,371)$(1,103,831)
As of December 31, 2020,2022, trade names having a carrying value of $239.1$230.3 million are considered indefinite-lived. Acquired IPR&D is indefinite-lived until the completion of the related development project, at which point amortization of the carrying value of the technology will commence.
F-20

TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Amortization expense related to intangible assets was $158.7$164.1 million, $150.0$165.6 million, and $149.5$158.7 million for the years ended December 31, 2022, 2021 and 2020, 2019 and 2018, respectively. EstimatedThe estimated annual amortization expense for each of the five succeeding years is as follows:
2021$167,000 
2022165,300 
20232023160,300 2023$167,100 
20242024159,100 2024165,000 
20252025158,100 2025164,100 
20262026161,300 
20272027158,100 

Note 9 — Leases
We have operating leases for various types of properties, consisting of manufacturing plants, engineering and research centers, distribution warehouses, offices and other facilities, and equipment used in operations. Some leases provide us with an option, exercisable at our sole discretion, to terminate the lease or extend the lease term for one or more years. When measuring assets and liabilities arising from a lease that provides us with an option to extend the lease term, we take into account payments to be made in the optional extension period when it is reasonably certain that we will exercise the option. Total lease cost (all of which related to operating leases) was $30.7$30.8 million, $30.2$32.6 million and $32.6$30.7 million for the years ended December 31, 2020, 20192022, 2021 and 2018,2020, respectively.

Maturities of lease liabilities
December 31, 2020
2021$26,178 
202223,540 
202318,222 
202414,047 
20257,853 
2026 and thereafter36,131 
Total lease payments125,971 
Less: interest(17,228)
Present value of lease liabilities$108,743 
December 31, 2022
2023$24,613 
202421,483 
202519,884 
202619,206 
202718,338 
2028 and thereafter63,242 
Total lease payments166,766 
Less: interest(26,872)
Present value of lease liabilities$139,894 

F-20

TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Supplemental information
December 31, 2020December 31, 2019
Total lease liabilities (1)
$108,743 $122,221 
Cash paid for amounts included in the measurement of lease liabilities within operating cash flows$28,276 $26,458 
Right of use assets obtained in exchange for operating lease obligations$8,904 $37,673 
Weighted average remaining lease term6.7 years7.2 years
Weighted average discount rate4.0 %4.4 %
December 31, 2022December 31, 2021
Total lease liabilities (1)
$139,894 $138,163 
Cash paid for amounts included in the measurement of lease liabilities within operating cash flows$28,308 $29,199 
Right of use assets obtained in exchange for operating lease obligations$25,202 $55,290 
Weighted average remaining lease term7.9 years7.9 years
Weighted average discount rate4.2 %3.7 %
(1) The current portion of the operating lease liability is included in other current liabilities.

F-21

TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Note 10 — Borrowings
Our borrowings at December 31, 20202022 and 20192021 were as follows:
2020201920222021
Senior Credit Facility:Senior Credit Facility:Senior Credit Facility:
Revolving credit facility, at a rate of 1.66% at December 31, 2020, and 3.12% at December 31, 2019, due 2024$350,000 $300,000 
Term loan facility, at a rate of 1.65% at December 31, 2020 and 3.17% at December 31 2019, due 2024673,000 673,000 
4.875% Senior Notes due 2026400,000 400,000 
Revolving credit facility, at a rate of 5.80% at December 31, 2022, and 1.48% at December 31, 2021, due 2027Revolving credit facility, at a rate of 5.80% at December 31, 2022, and 1.48% at December 31, 2021, due 2027$148,250 $141,000 
Term loan facility, at a rate of 5.80% at December 31, 2022 and 1.48% at December 31 2021, due 2027Term loan facility, at a rate of 5.80% at December 31, 2022 and 1.48% at December 31 2021, due 2027500,000 647,500 
4.625% Senior Notes due 20274.625% Senior Notes due 2027500,000 500,000 4.625% Senior Notes due 2027500,000 500,000 
4.25% Senior Notes due 20284.25% Senior Notes due 2028500,000 4.25% Senior Notes due 2028500,000 500,000 
Securitization program, at a rate of 1.24% at December 31, 2020 and 2.51% at December 31, 201975,000 50,000 
Securitization program, at a rate of 5.11% at December 31, 2022 and 1.00% at December 31, 2021Securitization program, at a rate of 5.11% at December 31, 2022 and 1.00% at December 31, 202175,000 75,000 
2,498,000 1,923,000  1,723,250 1,863,500 
Less: Unamortized debt issuance costsLess: Unamortized debt issuance costs(19,612)(14,057)Less: Unamortized debt issuance costs(11,727)(13,398)
2,478,388 1,908,943  1,711,523 1,850,102 
Current portion of borrowingsCurrent portion of borrowings(100,500)(50,000)Current portion of borrowings(87,500)(110,000)
Long-term borrowingsLong-term borrowings$2,377,888 $1,858,943 Long-term borrowings$1,624,023 $1,740,102 
Senior credit facility
In 2019,On November 4, 2022, we amended and restated our existing credit agreement by entering into a SecondThird Amended and Restated Credit Agreement (the "Credit Agreement"“Credit Agreement”), which provides for a five-year revolving credit facility of $1.0 billion and a term loan facility of $700.0 million (the "Credit Agreement").Our$500.0 million. The obligations under the Credit Agreement are guaranteed (subject to certain exceptions and limitations) by substantially all of our material domestic subsidiaries. The obligations under the Credit Agreement are secured, subject to certain exceptions and limitations, by a lien on substantially all of the assets owned by us and each guarantor. The maturity date of the revolving credit facility and the term loan facility under the Credit Agreement is April 5, 2024.November 4, 2027.
At our option, loans under the Credit Agreement will bear interest at a rate equal to adjusted LIBORTerm SOFR plus an applicable margin ranging from 1.25%1.125% to 2.00% or at an alternate base rate, which generally is defined as the highest of (i) the “Prime Rate” in the U.S. last quoted by The Wall Street Journal, (ii) 0.5%0.50% above the greater of the federal funds rate and the rate comprised of both overnight federal funds and overnight eurodollar borrowingstransactions denominated in Dollars and (iii) 1%1.00% above adjusted LIBORthe Term SOFR Rate for a one month interest period, plus in each case an applicable margin ranging from 0.125% to 1.00%, in each case subject to adjustments based on our consolidated total net leverage ratio. Overdue loans will bear interest at the rate otherwise applicable to such loans plus 2.00%.
The obligations to extend credit under the Credit Agreement are subject to customary conditions for transactions of this type.
The Credit Agreement contains customary representations and warranties and covenants that, in each case, subject to certain exceptions, qualifications and thresholds, (a) place limitations on us and our subsidiaries regarding the incurrence of additional indebtedness, additional liens, fundamental changes, dispositions of property, investments and acquisitions, dividends and other restricted payments, transactions with affiliates, restrictive agreements, changes in lines of business and swap agreements, and (b) require us and our subsidiaries to comply with sanction laws and other laws and agreements, to deliver financial information and certain other information and give notice of certain events, to maintain their existence and good standing, to pay their other obligations, to permit the administrative agent and the lenders to inspect their books and property, to use the proceeds of the Credit Agreement only for certain permitted
F-21

TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

purposes and to provide collateral in the future. Subject to certain exceptions, we are required to maintain a maximum consolidated total net leverage ratio of 4.50 to 1.00. We are further required to maintain a minimum consolidated interest coverage ratio of 3.50 to 1.00.
4.875% Senior notes due 2026
In 2016, we issued $400.0We capitalized transaction fees of $4.7 million, of 4.875% Senior Notes due 2026 (the "2026 Notes"). We pay interest onincluding underwriters' discounts and commissions, incurred in connection with the 2026 Notes semi-annually on June 1 and December 1 at a rate of 4.875% per year. The 2026 Notes mature on June 1, 2026, unless earlier redeemed by us at our option, as described below, or purchased by us at the holder’s option under specified circumstances following a Change of Control or Asset Sale (each as defined in the Indenture relatedthird amendment to the 2026 Notes) or upon our election to exercise its optional redemption rights, as described below.
Our obligations under the 2026 Notes are fully and unconditionally guaranteed, jointly and severally, by eachCredit Agreement. Additionally, we recognized a loss on extinguishment of our existing and future 100% owned domestic subsidiaries that is a guarantor or other obligor under the Credit Agreement and by certaindebt of the other 100% owned domestic subsidiaries.
At any time on or after June 1, 2021, we may, on one or more occasions, redeem some or all of the 2026 Notes at a redemption price of 102.438% of the principal amount of the 2026 Notes subject to redemption, declining, in annual increments of 0.813%, to 100% of the principal amount on June 1, 2024, plus accrued and unpaid interest. In addition, at any time prior to June 1, 2021, we may, on one or more occasions, redeem some or all of the 2026 Notes at a redemption price equal to 100% of the principal amount of the 2026 Notes redeemed, plus a “make-whole” premium and any accrued and unpaid interest. The “make-whole” premium is the greater of (a) 1.0% of the principal amount of the 2026 Notes subject to redemption or (b) the excess, if any, over the principal amount of the 2026 Notes of the present value, on the redemption date of the sum of (i) the June 1, 2021 optional redemption price plus (ii) all required interest payments on the 2026 Notes through June 1, 2021 (other than accrued and unpaid interest$0.5 million due to the redemption date), generally computed using a discount rate equal to the yield to maturitywrite off of U.S. Treasury securities with a constant maturity for the period most nearly equal to the period from the redemption date to June 1, 2021 (unless the period is less than one year, in which case the weekly average yield on traded U.S. Treasury securities adjusted to a constant maturity of one year will be used), plus 50 basis points.unamortized deferring financing costs.
The indenture relating to the 2026 Notes contains covenants that, among other things and subject to certain exceptions, limit or restrict our ability to incur additional debt or issue preferred stock or other disqualified stock; create liens; merge, consolidate or dispose of certain assets, make investments or make other restricted payments; or enter into transactions with affiliates.
F-22

TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

4.625% Senior notes due 2027
In 2017, we issued $500.0 million of 4.625% Senior Notes due 2027 (the "2027 Notes"). We pay interest on the 2027 Notes semi-annually on May 15 and November 15, commencing on May 15, 2018, at a rate of 4.625% per year. The 2027 Notes mature on November 15, 2027 unless earlier redeemed by us at our option, as described below, or purchased by us at the holder’s option under specified circumstances following a Change of Control or Asset Sale (each as defined in the indenture related to the 2027 Notes), coupled with a downgrade in the ratings of the 2027 Notes, or upon our election to exercise our optional redemption rights, as described below. We incurred transaction fees of $7.9 million, including underwriters’ discounts and commissions, in connection with the offering of the 2027 Notes, which were recorded on the consolidated balance sheet as a reduction to long-term borrowings and are being amortized over the term of the 2027 Notes. We used the net proceeds from the offering to repay borrowings under our revolving credit facility.
Our obligations under the 2027 Notes are fully and unconditionally guaranteed, jointly and severally, by each of our existing and future 100% owned domestic subsidiaries that is a guarantor or other obligor under the Credit Agreement and by certain of our other 100% owned domestic subsidiaries.
At any time on or afterAs of November 15, 2022, we may,became entitled, on one or more occasions, to redeem some or all of the 2027 Notes at a redemption price of 102.313% of the principal amount of the 2027 Notes subject to redemption, declining, in annual increments of 0.771%, to 100% of the principal amount on November 15, 2025, plus accrued and unpaid interest. In addition, at any time priorPrior to November 15, 2022, our redemption rights, which we may, on one or more occasions, redeem some or all of the 2027 Notes at a redemption price equal to 100% of the principal amount of the 2027 Notes redeemed, plus a “make-whole” premium and any accrued and unpaid interest. The “make-whole” premium is the greater of (a) 1.0% of the principal amount of the 2027 Notesdid not exercise, were subject to redemption or (b) the excess, if any, over the principal amount of the 2027 Notes of the present value, on the redemption date of the sum of (i) the November 15, 2022 optional redemption price plus (ii) all required interest payments on the 2027 Notes through
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November 15, 2022 (other than accrued and unpaid interest to the redemption date), generally computed using a discount rate equal to the yield to maturity of U.S. Treasury securities with a constant maturity for the period most nearly equal to the period from the redemption date to November 15, 2022 (unless the period is less than one year, in which case the weekly average yield on traded U.S. Treasury securities adjusted to a constant maturity of one year will be used), plus 50 basis points.
In addition, at any time prior to November 15, 2020, we may, on one or more occasions, redeem up to 40% of the aggregate principal amount of the 2027 Notes, using the proceeds of specified types of Company equity offerings and subject to specified conditions, at a redemption price equal to 104.625% of the principal amount of the Notes redeemed, plus accrued and unpaid interest.different terms.
The indenture relating to the 2027 Notes contains covenants that, among other things and subject to certain exceptions, limit or restrict our ability to create liens; merge, consolidate, sell or otherwise dispose of all or substantially all of our assets; or enter into sale leaseback transactions.
4.25% Senior Notes due 2028
In 2020, we issued $500.0 million of 4.25% Senior Notes due 2028 (the "2028 Notes"). We pay interest on the 2028 Notes semi-annually on June 1 and December 1, commencing on December 1, 2020, at a rate of 4.25% per year. The 2028 Notes mature on June 1, 2028 unless earlier redeemed at our option, as described below, or purchased at the holder’s option under specified circumstances following a Change of Control or Event of Default (each as defined in the indenture related to the 2028 Notes), coupled with a downgrade in the ratings of the 2028 Notes, or upon our election to exercise its optional redemption rights, as described below. We incurred transaction fees of $8.5 million, including underwriters’ discounts and commissions, in connection with the offering of the 2028 Notes, which were recorded on the consolidated balance sheet as a reduction to long-term borrowings and are being amortized over the term of the 2028 Notes. We used the net proceeds from the offering to repay borrowings under our revolving credit facility.
Our obligations under the 2028 Notes are fully and unconditionally guaranteed, jointly and severally, by each of our existing and future 100% owned domestic subsidiaries that is a guarantor or other obligor under the Credit Agreement and by certain of our other 100% owned domestic subsidiaries.
At any time on or after June 1, 2023, we may, on one or more occasions, redeem some or all of the 2028 Notes at a redemption price of 102.125% of the principal amount of the 2028 Notes subject to redemption, declining, in annual increments of 1.0625%, to 100% of the principal amount on June 1, 2025, plus accrued and unpaid interest. In addition, at any time prior to June 1, 2023, we may, on one or more occasions, redeem some or all of the 2028 Notes at a redemption price equal to 100% of the principal amount of the 2028 Notes redeemed, plus a “make-whole” premium and any accrued and unpaid interest. The “make-whole” premium is the greater of (a) 1.0% of the principal amount of the 2028 Notes subject to redemption or (b) the excess, if any, over the principal amount of the 2028 Notes, of the present value, on the redemption date, of the sum of (i) the June 1, 2023, optional redemption price plus (ii) all required interest payments on the 2028 Notes through June 1, 2023, (other than accrued and unpaid interest to the redemption date), generally computed using a discount rate equal to the yield to maturity of U.S. Treasury securities with a constant maturity for the period most nearly equal to the period from the redemption date to June 1, 2023 (unless the period is less than one year, in which case the weekly average yield on traded U.S. Treasury securities adjusted to a constant maturity of one year will be used), plus 50 basis points.
In addition, at any time prior to June 1, 2023, we may, on one or more occasions, redeem up to 40% of the aggregate principal amount of the 2028 Notes, using the proceeds of specified types of our equity offerings and
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subject to specified conditions, at a redemption price equal to 104.25% of the principal amount of the Notes redeemed, plus accrued and unpaid interest.
The indenture relating to the 2028 Notes contains covenants that, among other things, limit or restrict our ability, and the ability of our subsidiaries, to create liens; merge, consolidate, sell or otherwise dispose of all or substantially all of our assets; and enter into sale leaseback transactions.
Securitization program
We have an accounts receivable securitization facility under which accounts receivable of certain domestic subsidiaries are sold on a non-recourse basis to a special purpose entity (“SPE”), which is a bankruptcy-remote, consolidated subsidiary of Teleflex. Accordingly, the assets of the SPE are not available to satisfy the obligations of Teleflex or any of its subsidiaries. The SPE sells undivided interests in those receivables to an asset backed
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commercial paper conduit for consideration of up to the maximum available capacity. On March 30, 2020, we amended our accounts receivable securitization facility to increase the maximum available capacity from $50 million to $75 million. This facility is utilized from time to time to provide increased flexibility in funding short term working capital requirements. The agreement governing the accounts receivable securitization facility contains certain covenants and termination events. An occurrence of an event of default or a termination event under this facility may give rise to the right of its counterparty to terminate this facility. As of December 31, 2020,2022, we were in compliance with the covenants, and none of the termination events had occurred. As of December 31, 20202022 and 2019,2021, we had $75.0 million and $50.0 million, respectively, (the maximum amount available) of outstanding borrowings under itsour accounts receivable securitization facility.
Fair value of long-term debt
To determine the fair value of our debt for which quoted prices are not available, we use a discounted cash flow technique that incorporates a market interest yield curve with adjustments for duration, optionality and risk profile. Our implied credit rating is a factor in determining the market interest yield curve. The following table provides the fair value of our debt as of December 31, 20202022 and 2019,2021, which is valued based on Level 2 inputs within the hierarchy used to measure fair value (see Note 12 to the consolidated financial statements for further information):
December 31, 2020December 31, 2019
Fair value of debt$2,586,058 $1,974,918 
December 31, 2022December 31, 2021
Fair value of debt$1,674,232 $1,893,518 
Debt Maturities
As of December 31, 2020,2022, the aggregate amounts of long-term debt, demand loans and debt under our securitization program that will mature during each of the next four years and thereafter were as follows:
2021$100,500 
202235,000 
202343,750 
2024918,750 
2025 and thereafter1,400,000 
2023$87,500 
202412,500 
202525,000 
202625,000 
2027 and thereafter1,573,250 
Supplemental cash flow information
Year Ended December 31,
202020192018
Cash interest paid$79,533 $95,954 $101,790 
Year Ended December 31,
202220212020
Cash interest paid$70,918 $73,598 $79,533 

Note 11 — Financial instruments
Foreign currency forward contracts
We use derivative instruments for risk management purposes. Foreign currency forward contracts designated as cash flows hedges are used to manage foreign currency transaction exposure. Foreign currency forward contracts not designated as hedges for accounting purposes are used to manage exposure related to near term foreign currency denominated monetary assets and liabilities. We enter into the non-designated foreign currency forward contracts for periods consistent with itsthe currency exposures, which generally approximate one month. For the years ended December 31, 20202022 and 2019,2021, we recognized losses related to non-designated foreign currency forward contracts of $1.8$3.0 million and $3.8$8.9 million, respectively.
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The total notional amount for all open foreign currency forward contracts designated as cash flow hedges as of December 31, 20202022 and 20192021 was $129.5$184.8 million and $132.0$149.5 million, respectively. The total notional amount for all open non-designated foreign currency forward contracts as of December 31, 20202022 and 20192021 was $163.5$152.9 million and $145.1$161.2 million, respectively. All open foreign currency forward contracts as of December 31, 20202022 have durations of 12 months or less.
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Cross-currency interest rate swaps
During 2019, we entered into cross-currency swap agreements with 5five different financial institution counterparties to hedge against the effect of variability in the U.S. dollar to euro exchange rate. Under the terms of the cross-currency swap agreements, we have notionally exchanged $250 million at an annual interest rate of 4.8750% for €219.2 million at an annual interest rate of 2.4595%. The swap agreements are designed as net investment hedges and expire on March 4, 2024.
During 2018, we entered into cross-currency swap agreements with 6six different financial institution counterparties to hedge against the effect of variability in the U.S. dollar to euro exchange rate. Under the terms of the cross-currency swap agreements, we have notionally exchanged $500 million at an annual interest rate of 4.625% for €433.9 million at an annual interest rate of 1.942%. The swap agreements are designated as net investment hedges and expire on October 4, 2023.
The swap agreements described above require an exchange of the notional amounts upon expiration or earlier termination of the agreements. We and the counterparties have agreed to effect the exchange through a net settlement.
The cross-currency swaps are marked to market at each reporting date and any changes in fair value are recognized as a component of accumulated other comprehensive income (loss) ("AOCI") while the accrued interest is recognized in interest expense in the statement of operations. ForThe following table summarizes the yearsforeign exchange gains and losses recognized within AOCI and the interest benefit recognized within interest expense related to cross currency swap for the year ended December 31, 20202022 and 2019, we recognized a foreign exchange loss of $37.3 million and a gain of $20.8 million, respectively, in foreign currency translation adjustments within AOCI related to the cross-currency swaps. For the years ended December 31, 2020 and 2019, we recognized $14.5 million and $18.9 million, respectively, in interest benefit related to the cross-currency swaps.2021:
December 31, 2022December 31, 2021
Foreign exchange gains$22,399 $34,849 
Interest benefit20,880 19,296 
Balance sheet presentation
The following table presents the locations in the consolidated balance sheets and fair value of derivative instruments as of December 31, 20202022 and 2019:2021:
December 31, 2020December 31, 2019December 31, 2022December 31, 2021
Asset derivatives:Asset derivatives:Asset derivatives:
Designated foreign currency forward contractsDesignated foreign currency forward contracts$1,691 $1,659 Designated foreign currency forward contracts$3,154 $1,957 
Non-designated foreign currency forward contractsNon-designated foreign currency forward contracts61 192 Non-designated foreign currency forward contracts41 56 
Cross-currency interest rate swapCross-currency interest rate swap20,106 21,575 Cross-currency interest rate swap48,503 21,718 
Prepaid expenses and other current assetsPrepaid expenses and other current assets21,858 23,426 Prepaid expenses and other current assets51,698 23,731 
Cross-currency interest rate swapCross-currency interest rate swap13,066 Cross-currency interest rate swap11,912 9,560 
Other assetsOther assets13,066 Other assets11,912 9,560 
Total asset derivativesTotal asset derivatives$21,858 $36,492 Total asset derivatives$63,610 $33,291 
Liability derivatives:Liability derivatives:Liability derivatives:
Designated foreign currency forward contractsDesignated foreign currency forward contracts$1,504 $1,285 Designated foreign currency forward contracts$983 $993 
Non-designated foreign currency forward contractsNon-designated foreign currency forward contracts366 102 Non-designated foreign currency forward contracts477 147 
Other current liabilitiesOther current liabilities1,870 1,387 Other current liabilities1,460 1,140 
Cross-currency interest rate swap34,125 
Other liabilities34,125 
Total liability derivativesTotal liability derivatives$35,995 $1,387 Total liability derivatives$1,460 $1,140 
See Note 13 for information on the location and amount of gains and losses attributable to derivatives that were reclassified from AOCI to expense (income), net of tax.
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For the years ended December 31, 2020, 20192022, 2021 and 2018,2020, there was 0no ineffectiveness related to our hedging derivatives.

Note 12 — Fair value measurement
Fair value is the price that would be received from the sale of an asset or paid to transfer a liability, using assumptions that market participants would use in pricing an asset or liability. Under GAAP, there is a three-level
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hierarchy of the inputs (i.e., assumptions that market participants would use in pricing an asset or liability) used to measure fair value. The categorization within the valuation hierarchy is based on the lowest level of input that is significant to the entire fair value measurement.
The levels of inputs within the hierarchy used to measure fair value are as follows:
Level 1 — inputs to the fair value measurement that are quoted prices (unadjusted) in active markets for identical assets or liabilities.
Level 2 — inputs to the fair value measurement that include quoted prices for similar assets or liabilities in active markets; quoted prices for identical or similar assets or liabilities in markets that are not active; inputs other than quoted prices that are observable for the asset or liability; and inputs that are derived principally from or corroborated by observable market data by correlation or other means.
Level 3 — inputs to the fair value measurement that are unobservable inputs for the asset or liability.
The following tables provide information regarding our financial assets and liabilities measured at fair value on a recurring basis as of December 31, 20202022 and 2019:2021:
Basis of fair value measurementBasis of fair value measurement
December 31, 2020(Level 1)(Level 2)(Level 3)December 31, 2022(Level 1)(Level 2)(Level 3)
Investments in marketable securitiesInvestments in marketable securities$12,617 $12,617 $$Investments in marketable securities$10,097 $10,097 $— $— 
Derivative assetsDerivative assets21,858 21,858 Derivative assets63,610 — 63,610 — 
Derivative liabilitiesDerivative liabilities35,995 35,995 Derivative liabilities1,460 — 1,460 — 
Contingent consideration liabilitiesContingent consideration liabilities36,633 36,633 Contingent consideration liabilities44,022 — — 44,022 

Basis of fair value measurementBasis of fair value measurement
December 31, 2019(Level 1)(Level 2)(Level 3)December 31, 2021(Level 1)(Level 2)(Level 3)
Investments in marketable securitiesInvestments in marketable securities$10,926 $10,926 $$Investments in marketable securities$19,186 $19,186 $— $— 
Derivative assetsDerivative assets36,492 36,492 Derivative assets33,291 — 33,291 — 
Derivative liabilitiesDerivative liabilities1,387 1,387 Derivative liabilities1,140 — 1,140 — 
Contingent consideration liabilitiesContingent consideration liabilities219,908 219,908 Contingent consideration liabilities9,814 — — 9,814 
There were no transfers of financial assets or liabilities into or out of Level 3 within the fair value hierarchy during the years ended December 31, 20202022 or 2019.2021.
Valuation Techniques
Our financial assets valued based upon Level 1 inputs are comprised of investments in marketable securities held in trust, which are available to satisfy benefit obligations under Company benefit plans and other arrangements. The investment assets of the trust are valued using quoted market prices.
Our financial assets and liabilities valued based upon Level 2 inputs are comprised of foreign currency forward contracts and cross-currency interest rate swap agreements. We use foreign currency forward contracts and cross-currency interest rate swap agreements to manage foreign currency transaction exposure as well as exposure to foreign currency denominated monetary assets and liabilities. We measure the fair value of the foreign currency forward and cross-currency swap agreements by calculating the amount required to enter into offsetting contracts with similar remaining maturities, based on quoted market prices, and taking into account the creditworthiness of the counterparties.
Our financial liabilities valued based upon Level 3 inputs are comprised of contingent consideration arrangements pertaining to our acquisitions.
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Contingent consideration
Contingent consideration liabilities, which primarily consist of payment obligations that are contingent upon the achievement of revenue-based goals, but also can be based on other milestones such as regulatory approvals, are remeasured to fair value each reporting period using assumptions including estimated revenuesrevenue growth rates (based on internal operational budgets and long-range strategic plans), revenue volatility, discount rates, probability of payment and projected payment dates.
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We determine the fair value of thecertain contingent consideration liabilities using a Monte Carlo simulation (which involves a simulation of future revenues during the earn-out period using management's best estimates) or discounted cash flow analysis. Increases in projected revenues, estimated cash flows and probabilities of payment may result in significantly higher fair value measurements; decreases in these items may have the opposite effect. Increases in the discount rates in periods prior to payment may result in significantly lower fair value measurements and decreases in the discount rates may have the opposite effect. As of December 31, 2020,2022, the maximum amount we could be required to pay under the contingent consideration arrangements related to the Essential Medical and Z-Medica acquisitionsStandard Bariatrics acquisition was $91.9$130.0 million. See Note 17 for additional information regarding the revenue-based milestone goals related to our acquisition of Essential Medical.
The table below provides additional information regarding the valuation technique and inputs used in determining the fair value of our significant contingent consideration.consideration liabilities.
Contingent Consideration LiabilityValuation TechniqueUnobservable InputRange (Weighted average)
Milestone-based payment
Discounted cash flowDiscount rate1.3% - 2.3% (1.5%)
Projected year of payment2021 - 2023
Revenue-based
Monte Carlo simulationRevenue volatility22.4%31.8 %
Risk free rateCost of debt structure
Projected year of payment20212024 - 20222026
Discounted cash flowDiscount rate6.5% - 10.0% (9.1%)
Projected year of payment2021 - 2029
The following table provides information regarding changes in our contingent consideration liabilities for the years ended December 31, 20202022 and 2019:2021:
20202019
Beginning balance – January 1$219,908 $304,248 
Payments (1)
(146,971)(138,171)
Initial estimate upon acquisition and revaluations(36,714)53,915 
Translation adjustment410 (84)
Ending balance – December 31$36,633 $219,908 
(1) Consists mainly of a $140.6 million payment associated with our acquisition of NeoTract, Inc. ("Neotract") and resulting from the achievement of a revenue-based goal for the period from January 1, 2019 to December 31, 2019.
Contingent consideration
20222021
Beginning balance – January 1$9,814 $36,633 
Initial estimate upon acquisition38,800 — 
Payments(6,975)(31,678)
Revaluations and other adjustments2,350 4,895 
Translation adjustment33 (36)
Ending balance – December 31$44,022 $9,814 

Note 13 — Shareholders' equity
Our authorized capital is comprised of 200 million common shares, $1 par value, and 500,000 preference shares. No preference shares have been outstanding during the last three years.
Basic earnings per share is computed by dividing net income by the weighted average number of common shares outstanding during the period. Diluted earnings per share is computed in the same manner except that the weighted average number of shares is increased to include dilutive securities. The following table provides a reconciliation of basic to diluted weighted average shares outstanding:
202020192018 202220212020
BasicBasic46,488 46,200 45,689 Basic46,898 46,774 46,488 
Dilutive effect of share based awardsDilutive effect of share based awards799 890 970 Dilutive effect of share based awards411 653 799 
Dilutive effect of convertible notes and warrants142 
DilutedDiluted47,287 47,090 46,801 Diluted47,309 47,427 47,287 
Weighted average shares that were antidilutive and therefore excluded from the calculation of diluted earnings per share were 0.10.5 million 0.1 millionfor the year ended December 31, 2022, and 0.60.1 million for the years ended December 31, 2020, 20192021 and 2018, respectively.2020.
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The following tables provides information relating to the changes in accumulated other comprehensive income (loss), net of tax, for each of the years ended December 31, 20202022 and 2019:2021:
 
Cash Flow
Hedges
Pension and
Other
Postretirement
Benefit Plans
Foreign
Currency
Translation
Adjustment
Accumulated
Other
Comprehensive
Income (Loss)
Balance at December 31, 2018$807 $(131,380)$(210,512)$(341,085)
Other comprehensive income (loss) before reclassifications1,062 (12,811)4,195 (7,554)
Amounts reclassified from accumulated other comprehensive (loss) income(1,134)5,381 4,247 
Net current-year other comprehensive (loss) income(72)(7,430)4,195 (3,307)
Balance at December 31, 2019735 (138,810)(206,317)(344,392)
Other comprehensive (loss) income before reclassifications(3,331)(17,032)59,758 39,395 
Amounts reclassified from accumulated other comprehensive income2,114 5,585 7,699 
Net current-year other comprehensive (loss) income(1,217)(11,447)59,758 47,094 
Balance at December 31, 2020$(482)$(150,257)$(146,559)$(297,298)
 
Cash Flow
Hedges
Pension and
Other
Postretirement
Benefit Plans
Foreign
Currency
Translation
Adjustment
Accumulated
Other
Comprehensive
Income (Loss)
Balance at December 31, 2020$(482)$(150,257)$(146,559)$(297,298)
Other comprehensive income (loss) before reclassifications351 6,192 (63,191)(56,648)
Amounts reclassified from accumulated other comprehensive income1,212 5,775 — 6,987 
Net current-year other comprehensive income (loss)1,563 11,967 (63,191)(49,661)
Balance at December 31, 20211,081 (138,290)(209,750)(346,959)
Other comprehensive income (loss) before reclassifications7,179 (2,606)(62,904)(58,331)
Amounts reclassified from accumulated other comprehensive income(3,329)5,097 — 1,768 
Net current-year other comprehensive income (loss)3,850 2,491 (62,904)(56,563)
Balance at December 31, 2022$4,931 $(135,799)$(272,654)$(403,522)
The following table provides information relating to the (gains) losses (gains) recognized in the statements of income including the reclassifications of losses (gains) in accumulated other comprehensive (loss) income into expense/(income), net of tax, for the years ended December 31, 2020, 20192022, 2021 and 2018:2020:
Year Ended December 31,Year Ended December 31,
202020192018202220212020
Losses (gains) on designated foreign exchange forward contracts:
(Gains) losses on designated foreign exchange forward contracts:(Gains) losses on designated foreign exchange forward contracts:
Cost of goods soldCost of goods sold$2,354 $(1,284)$(2,270)Cost of goods sold$(3,532)$1,150 $2,354 
Total before taxTotal before tax2,354 (1,284)(2,270)Total before tax(3,532)1,150 2,354 
Taxes (benefit) expense(240)150 163 
Taxes expense (benefit)Taxes expense (benefit)203 62 (240)
Net of taxNet of tax$2,114 $(1,134)$(2,107)Net of tax$(3,329)$1,212 $2,114 
Amortization of pension and other postretirement benefits items:Amortization of pension and other postretirement benefits items:Amortization of pension and other postretirement benefits items:
Actuarial losses (1)
Actuarial losses (1)
$7,253 $6,930 $7,305 
Actuarial losses (1)
$7,660 $8,543 $7,253 
Prior-service credits (1)
Prior-service credits (1)
33 82 251 
Prior-service credits (1)
(1,017)(1,012)33 
Total before taxTotal before tax7,286 7,012 7,556 Total before tax6,643 7,531 7,286 
Tax benefitTax benefit(1,701)(1,631)(1,733)Tax benefit(1,546)(1,756)(1,701)
Net of taxNet of tax$5,585 $5,381 $5,823 Net of tax$5,097 $5,775 $5,585 
Impact on income from continuing operations, net of taxImpact on income from continuing operations, net of tax$7,699 $4,247 $3,716 Impact on income from continuing operations, net of tax$1,768 $6,987 $7,699 
(1)These accumulated other comprehensive (loss) income components are included in the computation of net benefit cost of pension and other postretirement benefit plans (see Note 16 for additional information).

Note 14 — Stock compensation plans
In May 2014, our stockholders approved the Teleflex Incorporated 2014 Stock Incentive Plan (the "2014 Plan""Plan") which replaced the 2008 Stock Incentive Plan and 2000 Stock Compensation Plan (the "Prior Plans"), under which stock options and restricted stock awards previously were granted.. The 2014 Plan provides for several different kinds of awards, including stock options, stock appreciation rights, stock awards and other stock-based awards to directors, officers and key employees. Under the 2014 Plan, we are authorized to issue up to 5.3 million shares of common stock, subject to adjustment in accordance with special share counting rules in the 2014 Plan that, among other things, (i) count shares underlying a stock option or stock appreciation right (each, an "option award") as 1 share and each share underlying any other type of award (a "stock award") as 1.8 shares, (ii) increase the shares we are authorized to issue by 1 or 1.8 shares for each share underlying an option award or stock award, respectively, under the Prior Plans that have been canceled, expired, settled in cash or forfeited after December 31, 2013 and (iii) decrease the number of shares we are authorized to issue by 1 share and 1.8 shares for each share underlying an option award or stock award, respectively, granted under the Prior Plans between January 1, 2014 and the May 2, 2014 adoption of the 2014 Plan by our stockholders.Plan. Options granted under the 2014 Plan have an exercise price equal to the closing price of the common stock on the date of the grant. In 2020,2022, we granted,
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under the 2014 Plan, non-qualified options to purchase 130,206156,918 shares of common stock and granted restricted stock units relating to 52,46485,780 shares of common stock under the 2014 Plan. We also granted performance share units (“PSUs”), as described in the following paragraph.
In 2018, we began granting PSUs to specified senior managers. The PSUs are designed to provide further incentive to our senior management with respect to the achievement of theour long term financial objectives. The PSU component of the equity incentive program is designed to provide shares of our common stock to the holder based upon our achievement of certain financial performance criteria during a designated performance period of three years. The number of shares to be awarded under the PSUs granted are subject to modification based upon our
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total stockholder return relative to a designated group of public companies. Assuming target performance is achieved, a total of 25,81825,131 shares of common stock would be issuable in respect of the PSUs granted and a maximum of 64,56262,927 shares would be issuable in respect of such PSUs upon achievement of maximum performance levels.
Thelevels.The following table summarizes the share-based compensation activity:
202020192018202220212020
(Dollars in millions)
Share-based compensation expenseShare-based compensation expense$20.7 $26.9 $22.4 Share-based compensation expense$27,224 $22,937 $20,739 
Total income tax benefit recognized for share-based compensation arrangementsTotal income tax benefit recognized for share-based compensation arrangements22.0 21.1 20.7 Total income tax benefit recognized for share-based compensation arrangements6,824 10,912 21,958 
Net excess tax benefitNet excess tax benefit17.5 15.4 15.9 Net excess tax benefit1,292 6,355 17,549 

The unrecognized compensation expense for all awards granted in 20202022 as of the grant date was $30.4$45.0 million, which will be recognized over the vesting period of the awards. As of December 31, 2020, 3,183,1992022, 2,843,121 shares were available for future grants under the 2014 Plan.
Option Awards
The fair value of options granted in 2020, 20192022, 2021 and 20182020 was estimated at the date of grant using a Black-Scholes option pricing model. The following weighted-average assumptions were used:
202020192018 202220212020
Risk-free interest rateRisk-free interest rate1.16 %2.44 %2.67 %Risk-free interest rate1.56 %0.67 %1.16 %
Expected life of optionExpected life of option5.00 years4.99 years4.98 yearsExpected life of option5.03 years5.01 years5.00 years
Expected dividend yieldExpected dividend yield0.39 %0.47 %0.54 %Expected dividend yield0.41 %0.34 %0.39 %
Expected volatilityExpected volatility23.98 %23.92 %22.65 %Expected volatility30.09 %30.03 %23.98 %
The following table summarizes the option activity during 2020:2022:
Shares Subject to OptionsWeighted Average Exercise PriceWeighted Average Remaining Contractual Life In Years
Aggregate
Intrinsic
Value
Shares Subject to OptionsWeighted Average Exercise PriceWeighted Average Remaining Contractual Life In Years
Aggregate
Intrinsic
Value
Outstanding, beginning of the yearOutstanding, beginning of the year1,325,532 $161.91 Outstanding, beginning of the year1,107,999 $214.13 
GrantedGranted130,206 347.64 Granted156,918 330.03 
ExercisedExercised(289,324)106.79 Exercised(27,518)95.07 
Forfeited or expiredForfeited or expired(9,099)290.49 Forfeited or expired(8,551)359.54 
Outstanding, end of the yearOutstanding, end of the year1,157,315 195.57 5.71$249,979 Outstanding, end of the year1,228,848 230.58 4.77$66,774 
Exercisable, end of the yearExercisable, end of the year903,680 $163.27 4.94$224,388 Exercisable, end of the year990,842 $201.19 3.84$66,746 
The weighted average grant date fair value for options granted during 2022, 2021 and 2020 2019was $88.92, $103.87 and 2018 was $74.60, $68.22 and $58.16, respectively. The total intrinsic value of options exercised during 2022, 2021 and 2020 2019 and 2018 was $77.9$5.0 million, $64.3$27.4 million and $69.4$77.9 million, respectively.
We recorded $9.4$10.3 million of expense related to options during 2020,2022, which is included in cost of goods sold or selling, general and administrative expenses. As of December 31, 2020,2022, the unamortized share-based compensation cost related to non-vested stock options, net of expected forfeitures, was $9.4$12.2 million, which is expected to be recognized over a weighted-average period of 1.451.65 years. Authorized but unissued shares of our common stock are issued upon exercises of options.
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TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Stock Awards
The fair value of PSUs granted in 2019 waswere determined using a Monte Carlo simulation valuation model. The grant date fair value for thesethe 2022 awards was $362.78.$301.00.
The fair value for restricted stock units granted in 2020, 20192022, 2021 and 20182020 was estimated at the date of grant based on the market price for the underlying stock on the grant date discounted for the risk free interest rate and the present value of expected dividends over the vesting period. The following weighted-average assumptions were used:
202020192018
Risk-free interest rate1.07 %2.41 %2.41 %
Expected dividend yield0.38 %0.46 %0.53 %
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TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

used:
202220212020
Risk-free interest rate1.57 %0.28 %1.07 %
Expected dividend yield0.42 %0.34 %0.38 %
The following table summarizes the non-vested restricted stock unit activity during 2020:2022:
Number of
Non-Vested
Shares
Weighted
Average
Grant-Date
Fair Value
Weighted
Average
Remaining
Contractual
Life
Aggregate
Intrinsic
Value
Number of
Non-Vested
Shares
Weighted
Average
Grant-Date
Fair Value
Weighted
Average
Remaining
Contractual
Life
Aggregate
Intrinsic
Value
Outstanding, beginning of the yearOutstanding, beginning of the year177,348 $240.17 Outstanding, beginning of the year135,378 $343.89 
GrantedGranted52,464 344.70 Granted85,780 323.35 
VestedVested(67,851)195.95 Vested(51,831)290.75 
ForfeitedForfeited(10,718)285.37 Forfeited(21,359)352.06 
Outstanding, end of the yearOutstanding, end of the year151,243 $293.06 1.2$62,236 Outstanding, end of the year147,968 $349.42 1.5$36,970 
We issued 52,464, 69,79985,780, 59,210 and 62,22152,464 of non-vested restricted stock units in 2020, 20192022, 2021 and 2018,2020, respectively, the majority of which provide for vesting as to all underlying shares on the third anniversary of the grant date. The weighted average grant-date fair value for non-vested restricted stock units granted during 2022, 2021 and 2020 2019was $323.35, $398.59 and 2018 was $344.70, $286.51 and $250.66, respectively.
We recorded $14.8$15.7 million of expense related to stock awards during 2020,2022, which is included in cost of goods sold or selling, general and administrative expenses. As of December 31, 2020,2022, the unamortized share-based compensation cost related to non-vested restricted stock units, net of estimated forfeitures, was $16.2$21.2 million, which is expected to be recognized over a weighted-average period of 1.21.5 years. We use treasury stock to provide shares of common stock in connection with vesting of the stock awards.

Note 15 — Income taxes
The following table summarizes the components of the provision for income taxes from continuing operations:
202020192018202220212020
Current:Current:Current:
FederalFederal$11,148 $19,374 $(1,525)Federal$32,798 $134,336 $11,148 
StateState9,644 8,220 1,432 State8,747 16,970 9,644 
Non-U.S.Non-U.S.35,042 23,690 29,353 Non-U.S.56,442 35,399 35,042 
Deferred:Deferred:Deferred:
FederalFederal(9,475)(2,041)(5,124)Federal(27,528)(85,272)(9,475)
StateState(13,734)(28,277)(5,114)State10,116 (16,933)(13,734)
Non-U.S.Non-U.S.(10,694)(143,044)4,174 Non-U.S.2,428 (10,151)(10,694)
$21,931 $(122,078)$23,196 $83,003 $74,349 $21,931 
At December 31, 2020,2022, the cumulative unremitted earnings of subsidiaries outside the U.S. that are considered non-permanently reinvested and for which taxes have been provided approximated $1.7$1.1 billion. At December 31, 2020,2022, the cumulative unremitted earnings of subsidiaries outside the U.S. that are considered permanently reinvested approximated $0.7$1.2 billion. Earnings considered permanently reinvested are expected to be reinvested indefinitely and, as a result, no additional deferred tax liability has been recognized with regard to these earnings. It is not practical to determine the deferred income tax liability on these earnings if, in the future, they are
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TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

remitted to the U.S. because the income tax liability to be incurred, if any, is dependent on circumstances existing when remittance occurs.
F-30


The following table summarizes the U.S. and non-U.S. components of income from continuing operations before taxes:
202020192018202220212020
U.S.U.S.$233,034 $89,021 $37,201 U.S.$164,151 $209,231 $233,034 
Non-U.S.Non-U.S.124,698 250,882 182,427 Non-U.S.281,768 350,237 124,698 
$357,732 $339,903 $219,628 $445,919 $559,468 $357,732 
Reconciliations between the statutory federal income tax rate and the effective income tax rate are as follows:
202020192018
Federal statutory rate21.0 %21.0 %21.0 %
Tax effect of international items(5.3)(11.3)(3.3)
Impacts of the TCJA (1)
(1.0)
Foreign Merger - Deferred Taxes (2)
(38.0)
Excess tax benefits related to share-based compensation(4.9)(4.5)(7.2)
State taxes, net of federal benefit(0.3)(4.9)(0.1)
Uncertain tax contingencies(0.5)(0.4)
Contingent consideration(2.2)3.4 5.3 
Intellectual property impairment charge(1.2)(2.0)
Research and development tax credit(1.1)(1.1)(1.6)
Other, net0.6 (0.5)(0.1)
6.1 %(35.9)%10.6 %
(1)U.S. tax legislation commonly referred to as the Tax Cuts and Jobs Act (the "TCJA") was enacted on December 22, 2017. The legislation significantly changed U.S. tax law by, among other things, reducing the corporate income tax rate and imposing a one-time repatriation tax on undistributed post-1986 non-U.S. subsidiary earnings and profits. This legislation required significant one-time adjustments to our consolidated tax provision.
(2)During 2019, we recognized a discrete tax benefit of $129.0 million resulting from a non-U.S. legal entity restructuring that eliminated the requirement to provide for withholding taxes on the future repatriation of certain non-permanently reinvested earnings.
202220212020
Federal statutory rate21.0 %21.0 %21.0 %
Tax effect of international items(4.6)(6.0)(5.3)
Foreign merger - deferred taxes— — — 
Excess tax benefits related to share-based compensation(0.3)(1.1)(4.9)
State taxes, net of federal benefit3.4 0.1 (0.3)
Uncertain tax contingencies(0.4)(0.1)(0.5)
Contingent consideration0.1 0.2 (2.2)
Intellectual property impairment charge— — (1.2)
Research and development tax credit(1.0)(0.8)(1.1)
Other, net0.5 — 0.6 
18.6 %13.3 %6.1 %
The effective income tax rate for 20202022 was 6.1%18.6% compared to (35.9)%13.3% for 2019. Taxes on income from continuing operations in 2020 reflects non-taxable contingent consideration adjustments, recognized in connection with a decrease in the fair value of our contingent consideration liabilities.2021. The effective income tax rate for 20192022 reflects a tax benefit of $129.0 millionexpense resulting from a non-U.S. legal entity restructuring that eliminateddeferred charge relating to the requirement to provide for withholding taxes on the future repatriation2022 Restructuring Plan and from a U.S. law effective in 2022 requiring capitalization of certain non-permanently reinvested earnings.research and development expenditures. The effective income tax rate for 2021 reflects tax expense associated with the Respiratory business divestiture. Additionally, the effective tax rates for both 20202022 and 20192021 reflect a net excess tax benefit related to share-based compensation and a tax benefit relating to the revaluation of state deferredfrom research and development tax assets and liabilities due to business integrations and other changes.credits.
We are routinely subject to examinations by various taxing authorities. In conjunction with these examinations and as a regular practice, we establish and adjust reserves with respect to its uncertain tax positions to address developments related to those positions. We realized a net benefit of $2.0 million, $0.8 million and $1.7 million $0.1 millionin 2022, 2021 and $0.8 million in 2020 2019 and 2018 respectively, as a result of reducing our reserves with respect to uncertain tax positions, principally due to the expiration of a number of applicable statutes of limitations.
F-31

TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

The following table summarizes significant components of our deferred tax assets and liabilities at December 31, 20202022 and 2019:2021:
2020201920222021
Deferred tax assets:Deferred tax assets:Deferred tax assets:
Tax loss and credit carryforwardsTax loss and credit carryforwards$180,782 $174,997 Tax loss and credit carryforwards$110,857 $168,113 
Lease assets25,429 28,577 
Lease LiabilitiesLease Liabilities32,339 32,127 
PensionPension12,237 14,971 Pension1,163 350 
Reserves and accrualsReserves and accruals72,931 60,799 Reserves and accruals64,498 64,421 
OtherOther7,996 3,207 Other24,013 4,379 
Less: valuation allowancesLess: valuation allowances(155,008)(119,233)Less: valuation allowances(91,531)(143,177)
Total deferred tax assetsTotal deferred tax assets144,367 163,318 Total deferred tax assets141,339 126,213 
Deferred tax liabilities:Deferred tax liabilities:Deferred tax liabilities:
Property, plant and equipmentProperty, plant and equipment25,633 23,053 Property, plant and equipment25,427 24,479 
Intangibles — stock acquisitionsIntangibles — stock acquisitions476,150 441,079 Intangibles — stock acquisitions379,298 352,139 
Unremitted non-U.S. earningsUnremitted non-U.S. earnings91,539 81,967 Unremitted non-U.S. earnings67,833 73,385 
Lease liabilities25,429 28,577 
Lease AssetsLease Assets32,339 32,127 
OtherOther2,221 22,628 Other18,926 7,387 
Total deferred tax liabilitiesTotal deferred tax liabilities620,972 597,304 Total deferred tax liabilities523,823 489,517 
Net deferred tax liabilityNet deferred tax liability$(476,605)$(433,986)Net deferred tax liability$(382,484)$(363,304)
Under the tax laws of various jurisdictions in which we operate, deductions or credits that cannot be fully utilized for tax purposes during the current year may be carried forward, subject to statutory limitations, to reduce taxable income or taxes payable in a future tax year. At December 31, 2020,2022, the tax effect of such carryforwards approximated $180.8$110.9 million. Of this amount, $14.4$16.0 million has no expiration date, $9.1$20.1 million expires after 20202022 but before the end of 20252027 and $157.3$74.8 million expires after 2025.2027. A portion of these carryforwards consists of tax losses and credits obtained by us as a result of acquisitions; the utilization of these carryforwards areis subject to an annual limitation imposed by Section 382 of the Internal Revenue Code, which limits a company’s ability to deduct prior net operating losses following a more than 50 percent change in ownership. It is not expected that the Section 382 limitation will prevent us ultimately from utilizing the applicable loss carryforwards. The determination of state net operating loss carryforwards is dependent upon the U.S. subsidiaries’ taxable income or loss, the state’s proportion of each subsidiary's taxable net income and the application of state laws, which can change from year to year and impact the amount of such carryforward.
The valuation allowance for deferred tax assets of $155.0$91.5 million and $119.2$143.2 million at December 31, 20202022 and 2019,2021, respectively, relates principally to the uncertainty of our ability to utilize certain deferred tax assets, primarily tax loss and credit carryforwards in various jurisdictions. The valuation allowance was calculated in accordance with applicable accounting standards, which require that a valuation allowance be established and maintained when it is “more likely than not” that all or a portion of deferred tax assets will not be realized.
Uncertain Tax Positions: The following table is a reconciliation of the beginning and ending balances for liabilities associated with unrecognized tax benefits for the years ended December 31, 2020, 20192022, 2021 and 2018:2020:
202020192018202220212020
Balance at January 1Balance at January 1$7,561 $8,106 $9,336 Balance at January 1$6,105 $7,230 $7,561 
Increase in unrecognized tax benefits related to prior yearsIncrease in unrecognized tax benefits related to prior years1,286 351 Increase in unrecognized tax benefits related to prior years215 — 1,286 
Decrease in unrecognized tax benefits related to prior yearsDecrease in unrecognized tax benefits related to prior years(201)Decrease in unrecognized tax benefits related to prior years(761)— — 
Unrecognized tax benefits related to the current year1,237 899 
Reductions in unrecognized tax benefits due to lapse of applicable statute of limitationsReductions in unrecognized tax benefits due to lapse of applicable statute of limitations(1,864)(1,881)(1,955)Reductions in unrecognized tax benefits due to lapse of applicable statute of limitations(1,117)(956)(1,864)
Increase (decrease) in unrecognized tax benefits due to foreign currency translation247 (51)(174)
(Decrease) increase in unrecognized tax benefits due to foreign currency translation(Decrease) increase in unrecognized tax benefits due to foreign currency translation(182)(169)247 
Balance at December 31Balance at December 31$7,230 $7,561 $8,106 Balance at December 31$4,260 $6,105 $7,230 
The total liabilities associated with the unrecognized tax benefits that, if recognized, would impact the effective tax rate for continuing operations, were $4.4$2.7 million at December 31, 2020.2022.
F-32

TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

We accrue interest and penalties associated with unrecognized tax benefits in income tax expense in the consolidated statements of income, and the corresponding liability is included in the consolidated balance sheets. The net interest expense (benefit) and penalties reflected in income from continuing operations for the year ended December 31, 20202022 was $0.2 million and $(0.5)$(0.2) million, respectively; for the year ended December 31, 20192021 was $0.2 million and $(0.1)$(0.3) million, respectively; and for the year ended December 31, 20182020 was $0.2 million and $(0.3)$(0.5) million, respectively. The liabilities in the consolidated balance sheets for interest and penalties at December 31, 20202022 were $0.6 million and $2.1$1.5 million, respectively, and at December 31, 20192021 were $0.6$0.8 million and $2.2$1.8 million, respectively.
The taxable years for which the applicable statute of limitations remains open by major tax jurisdictions are as follows:
BeginningEnding BeginningEnding
U.S.U.S.20172020U.S.20192022
CanadaCanada20162020Canada20182022
ChinaChina20152020China20172022
Czech RepublicCzech Republic20172020Czech Republic20192022
FranceFrance20182020France20192022
GermanyGermany20112020Germany20112022
IndiaIndia20022020India20022022
IrelandIreland20162020Ireland20182022
ItalyItaly20162020Italy20172022
MalaysiaMalaysia20162020Malaysia20152022
SingaporeSingapore20162020Singapore20182022
We are routinely subject to income tax examinations by various taxing authorities. As of December 31, 2020,2022, the most significant tax examinations in process were in Ireland, Germany and Germany.France. The date at which this examinationthese examinations may be concluded and the ultimate outcome of the examinationexaminations are uncertain. As a result of the uncertain outcome of thisthese ongoing examination,examinations, future examinations or the expiration of statutes of limitation, it is reasonably possible that the related unrecognized tax benefits for tax positions taken could materially change from those recorded as liabilities at December 31, 2020.2022. Due to the potential for resolution of certain examinations, and the expiration of various statutes of limitation,limitations, it is reasonably possible that our unrecognized tax benefits may change within the next year by a range of 0zero to $0.7$2.0 million.
Supplemental cash flow information
Year Ended December 31,
202020192018
Income taxes paid, net of refunds$77,163 $73,632 $65,605 
Year Ended December 31,
202220212020
Income taxes paid, net of refunds$162,046 $108,609 $77,163 

Note 16 — Pension and other postretirement benefits
We have a number of defined benefit pension and postretirement plans covering eligible U.S. and non-U.S. employees. The defined benefit pension plans are noncontributory. The benefits under these plans are based primarily on years of service and employees’ pay near retirement. Our funding policy for U.S. plans is to contribute annually, at a minimum, amounts required by applicable laws and regulations. Obligations under non-U.S. plans are systematically provided for by depositing funds with trustees or by book reserves. As of December 31, 2020,2022, no further benefits are being accrued under the U.S. defined benefit pension plans and the other postretirement benefit plans, other than certain postretirement benefit plans covering employees subject to a collective bargaining agreement.
Teleflex and certain of our subsidiaries provide medical, dental and life insurance benefits to pensioners or their survivors. The associated plans are unfunded and approved claims are paid from our funds.
F-33

TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

The following table provides information regarding the components of the net benefit (income) expense of the pension and postretirement benefit plans for the years ended December 31, 2020, 20192022, 2021 and 2018:2020:
PensionOther BenefitsPensionOther Benefits
202020192018202020192018202220212020202220212020
Service costService cost$1,416 $2,768 $1,500 $$$50 Service cost$1,346 $1,467 $1,416 $— $— $— 
Interest costInterest cost12,827 16,000 14,816 902 1,391 1,389 Interest cost10,776 9,272 12,827 477 418 902 
Expected return on plan assetsExpected return on plan assets(31,650)(27,426)(29,666)Expected return on plan assets(25,776)(30,726)(31,650)— — — 
Net amortization and deferralNet amortization and deferral7,447 7,013 6,777 (161)(1)136 Net amortization and deferral7,900 8,589 7,447 (1,258)(1,058)(161)
Curtailments677 
Settlements486 
Net benefit (income) expenseNet benefit (income) expense$(9,960)$(1,645)$(6,087)$741 $1,399 $2,252 Net benefit (income) expense$(5,754)$(11,398)$(9,960)$(781)$(640)$741 
Net benefit (income) expense is primarily included in selling, general and administrative expenses within the consolidated statements of income.
The following table provides the weighted average assumptions for U.S. and foreign plans used in determining net benefit cost:
PensionOther BenefitsPensionOther Benefits
202020192018202020192018202220212020202220212020
Discount rateDiscount rate3.2 %4.3 %3.6 %3.1 %4.2 %3.6 %Discount rate2.8 %2.5 %3.2 %2.7 %2.3 %3.1 %
Rate of returnRate of return7.5 %7.7 %7.8 %Rate of return5.6 %6.7 %7.5 %
Initial healthcare trend rateInitial healthcare trend rate7.0 %7.4 %7.8 %Initial healthcare trend rate6.4 %6.8 %7.0 %
Ultimate healthcare trend rateUltimate healthcare trend rate5.0 %5.0 %5.0 %Ultimate healthcare trend rate4.5 %4.5 %5.0 %
The following table provides summarized information with respect to the pension and postretirement benefit plans, measured as of December 31, 20202022 and 2019:2021:
PensionOther BenefitsPensionOther Benefits
20202019202020192022202120222021
Benefit obligation, beginning of yearBenefit obligation, beginning of year$470,236 $416,470 $40,042 $42,115 Benefit obligation, beginning of year$474,674 $501,347 $26,804 $31,921 
Service costService cost1,416 2,768 Service cost1,346 1,467 — — 
Interest costInterest cost12,827 16,000 902 1,391 Interest cost10,776 9,272 477 418 
Actuarial loss36,726 57,525 964 1,551 
Actuarial (gain) lossActuarial (gain) loss(104,558)(13,567)(6,223)(2,288)
Currency translationCurrency translation2,273 229 Currency translation(3,030)(1,726)— — 
Benefits paidBenefits paid(21,092)(20,350)(5,448)(5,090)Benefits paid(21,472)(21,138)(2,491)(3,303)
Medicare Part D reimbursementMedicare Part D reimbursement119 66 Medicare Part D reimbursement— — 53 56 
Plan amendments47 (4,658)
Administrative costsAdministrative costs(1,086)(2,406)Administrative costs(979)(981)— — 
Projected benefit obligation, end of yearProjected benefit obligation, end of year501,347 470,236 31,921 40,042 Projected benefit obligation, end of year356,757 474,674 18,620 26,804 
Fair value of plan assets, beginning of yearFair value of plan assets, beginning of year423,300 362,807 Fair value of plan assets, beginning of year469,793 457,626 
Actual return on plan assetsActual return on plan assets43,276 69,918 Actual return on plan assets(89,506)22,124 
ContributionsContributions12,490 12,695 Contributions1,464 12,159 
Benefits paidBenefits paid(21,092)(20,350)Benefits paid(21,472)(21,138)
Administrative costsAdministrative costs(1,086)(2,406)Administrative costs(979)(981)
Currency translationCurrency translation738 636 Currency translation(2,030)
Fair value of plan assets, end of yearFair value of plan assets, end of year457,626 423,300 Fair value of plan assets, end of year357,270 469,793 
Funded status, end of yearFunded status, end of year$(43,721)$(46,936)$(31,921)$(40,042)Funded status, end of year$513 $(4,881)$(18,620)$(26,804)

The actuarial lossesgain for pension for the yearsyear ended December 31, 2020 and 2019 were2022 was primarily due to a decreasean increase in the discount rate used to measure the obligation. The actuarial gain for pension for the year ended December 31, 2021 was primarily due to an increase in the discount rate used to measure the obligation, partially offset by a changedecreases from changes in thecensus data and mortality assumptions.
F-34

TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

The accumulated benefit obligations (ABO) and the projected benefit obligations (PBO) for plans with ABO and PBO in excess of plan assets were $481.0$345.5 million and $481.8$346.0 million, respectively, at December 31, 20202022 and $451.8$456.0 million and $452.4$456.6 million respectively, at December 31, 2019.2021. The fair value of plan assets for plans with PBO and ABO in excess of plan assets were $434.3$345.7 million and $403.0$449.8 million, respectively, at December 31, 20202022 and December 31, 2019,2021, respectively.
The following table sets forth the amounts recognized in the consolidated balance sheet with respect to the pension and postretirement plans:
PensionOther BenefitsPensionOther Benefits
20202019202020192022202120222021
Other assetsOther assets$3,703 $2,449 $$Other assets$16,870 $17,827 $— $— 
Payroll and benefit-related liabilitiesPayroll and benefit-related liabilities(1,721)(1,617)(3,125)(5,091)Payroll and benefit-related liabilities(1,408)(1,602)(2,175)(2,725)
Pension and postretirement benefit liabilitiesPension and postretirement benefit liabilities(45,703)(47,768)(28,796)(34,951)Pension and postretirement benefit liabilities(14,949)(21,106)(16,445)(24,079)
Accumulated other comprehensive loss (gain)Accumulated other comprehensive loss (gain)232,540 213,989 (1,617)1,916 Accumulated other comprehensive loss (gain)219,555 218,139 (7,812)(2,847)
$188,819 $167,053 $(33,538)$(38,126)$220,068 $213,258 $(26,432)$(29,651)
The following tables set forth the amounts recognized in accumulated other comprehensive income with respect to the plans:
PensionPension
Prior Service
Cost
Net (Gain)
or Loss
Deferred
Taxes
Accumulated Other Comprehensive
Loss, Net of Tax
Prior Service
Cost
Net (Gain)
or Loss
Deferred
Taxes
Accumulated Other Comprehensive
Loss, Net of Tax
Balance at December 31, 2018$191 $205,719 $(74,429)$131,481 
Balance at December 31, 2020Balance at December 31, 2020$205 $232,335 $(80,657)$151,883 
Reclassification adjustments related to components of Net Periodic Benefit Cost recognized during the period:Reclassification adjustments related to components of Net Periodic Benefit Cost recognized during the period:Reclassification adjustments related to components of Net Periodic Benefit Cost recognized during the period:
Net amortization and deferralNet amortization and deferral(18)(6,995)1,631 (5,382)Net amortization and deferral(5)(8,584)1,999 (6,590)
Amounts arising during the period:Amounts arising during the period:Amounts arising during the period:
Actuarial changes in benefit obligationActuarial changes in benefit obligation15,033 (3,457)11,576 Actuarial changes in benefit obligation— (4,965)1,148 (3,817)
Impact of currency translationImpact of currency translation59 (15)44 Impact of currency translation— (847)237 (610)
Balance at December 31, 2019173 213,816 (76,270)137,719 
Balance at December 31, 2021Balance at December 31, 2021200 217,939 (77,273)140,866 
Reclassification adjustments related to components of Net Periodic Benefit Cost recognized during the period:Reclassification adjustments related to components of Net Periodic Benefit Cost recognized during the period:Reclassification adjustments related to components of Net Periodic Benefit Cost recognized during the period:
Net amortization and deferralNet amortization and deferral(15)(7,432)1,738 (5,709)Net amortization and deferral— (7,900)1,832 (6,068)
Amounts arising during the period:Amounts arising during the period:Amounts arising during the period:
Actuarial changes in benefit obligationActuarial changes in benefit obligation25,100 (5,875)19,225 Actuarial changes in benefit obligation— 10,724 (2,271)8,453 
Plan amendments47 (9)38 
Impact of currency translationImpact of currency translation851 (241)610 Impact of currency translation— (1,408)365 (1,043)
Balance at December 31, 2020$205 $232,335 $(80,657)$151,883 
Balance at December 31, 2022Balance at December 31, 2022$200 $219,355 $(77,347)$142,208 
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TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Other Benefits
Prior Service
Cost
Net (Gain) or
Loss
Deferred
Taxes
Accumulated Other Comprehensive
Loss, Net of Tax
Balance at December 31, 2018$71 $293 $(465)$(101)
Reclassification adjustments related to components of Net Periodic Benefit Cost recognized during the period:
Net amortization and deferral(64)65 
Amounts arising during the period:
Actuarial changes in benefit obligation1,551 (360)1,191 
Balance at December 31, 20191,909 (825)1,091 
Reclassification adjustments related to components of Net Periodic Benefit Cost recognized during the period:
Net amortization and deferral(18)179 (37)124 
Amounts arising during the period:
Actuarial changes in benefit obligation964 (223)741 
Plan amendments(4,658)1,076 (3,582)
Balance at December 31, 2020$(4,669)$3,052 $(9)$(1,626)
Other Benefits
Prior Service
Cost
Net (Gain) or
Loss
Deferred
Taxes
Accumulated Other Comprehensive
Loss, Net of Tax
Balance at December 31, 2020$(4,669)$3,052 $(9)$(1,626)
Reclassification adjustments related to components of Net Periodic Benefit Cost recognized during the period:
Net amortization and deferral1,017 41 (243)815 
Amounts arising during the period:
Actuarial changes in benefit obligation— (2,288)523 (1,765)
Balance at December 31, 2021(3,652)805 271 (2,576)
Reclassification adjustments related to components of Net Periodic Benefit Cost recognized during the period:
Net amortization and deferral1,017 241 (287)971 
Amounts arising during the period:
Actuarial changes in benefit obligation— (6,223)1,419 (4,804)
Balance at December 31, 2022$(2,635)$(5,177)$1,403 $(6,409)
The following table provides the weighted average assumptions for U.S. and foreign plans used in determining benefit obligations:
PensionOther BenefitsPensionOther Benefits
20202019202020192022202120222021
Discount rateDiscount rate2.5 %3.2 %2.3 %3.1 %Discount rate5.1 %2.8 %5.1 %2.7 %
Rate of compensation increaseRate of compensation increase2.8 %2.8 %Rate of compensation increase3.0 %2.8 %
Initial healthcare trend rateInitial healthcare trend rate6.4 %6.6 %Initial healthcare trend rate5.9 %6.0 %
Ultimate healthcare trend rateUltimate healthcare trend rate4.5 %5.0 %Ultimate healthcare trend rate4.5 %4.5 %
The discount rate represents the interest rate used to determine the present value of future cash flows currently expected to be required to settle the pension and other benefit obligations. The weighted average discount rates for U.S. pension plans and other benefit plans of 2.64%5.20% and 2.29%5.13%, respectively, were established by comparing the projection of expected benefit payments to the AA Above Median yield curve as of December 31, 2020.2022. The expected benefit payments are discounted by each corresponding discount rate on the yield curve. For payments beyond 30 years, we extend the curve assuming that the discount rate derived in year 30 is extended to the end of the plan’s payment expectations. Once the present value of the string of benefit payments is established, we determine the single rate on the yield curve that, when applied to all obligations of the plan, will exactly match the previously determined present value.
As part of the evaluation of pension and other postretirement assumptions, we applied assumptions for mortality and healthcare cost trends that incorporate generational white and blue collar mortality trends. In determining its benefit obligations, we used generational tables that take into consideration increases in plan participant longevity.
Our assumption for the expected return on plan assets is primarily based on the determination of an expected return for its current portfolio. This determination is made using assumptions for return and volatility of the portfolio. Asset class assumptions are set using a combination of empirical and forward-looking analysis. To the extent historical results have been affected by unsustainable trends or events, the effects of those trends are quantified and removed. We apply a variety of models for filtering historical data and isolating the fundamental characteristics of asset classes. These models provide empirical return estimates for each asset class, which are then reviewed and combined with a qualitative assessment of long term relationships between asset classes before a return estimate is finalized. The qualitative analysis is intended to provide an additional means for addressing the effect of unrealistic or unsustainable short-term valuations or trends, resulting in return levels and behavior we believe are more likely to prevail over long periods. Effective in 2021,2022, we changed the expected return on plan assets of the U.S. pension plans from 7.75%5.80% to 7.00%7.40% due to modifications to the investment strategy in order to gradually reduce portfolio risk. The change had no impactreflect expected return assumptions based on the results for the year ended December 31, 2020.

recent capital market movements.
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TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

The accumulated benefit obligation for all U.S. and foreign defined benefit pension plans was $500.6$356.3 million and $469.6$474.1 million for 20202022 and 2019,2021, respectively. All of the pension plans had accumulated benefit obligations in excess of their respective plan assets as of December 31, 20202022 and 2019,2021, with the exception of one foreign plan that had plan assets of $3.7$0.8 million and $2.4$2.0 million in excess of the accumulated benefit obligation as of December 31, 20202022 and 2019,2021, respectively.
Our investment objective is to achieve an enhanced long-term rate of return on plan assets, subject to a prudent level of portfolio risk, for the purpose of enhancing the availability of benefits for participants. These investments are primarily comprised of equity and fixed income mutual funds. Our other investments are largely comprised of a hedge fund of funds and a structured credit fund. The equity funds are diversified in terms of domestic and international equity securities, as well as small, middle and large capitalization stocks. Our target allocation percentage is as follows: equity securities (41%(26%); and fixed-income securities (54%) and other securities (5%(74%). Equity funds are held for their expected return over inflation. Fixed-income funds are held for diversification relative to equities and as a partial hedge of interest rate risk with respect to plan liabilities. The other investments are held to further diversify assets within the plans and are designed to provide a mix of equity and bond like return with a bond like risk profile. The plans may also hold cash to meet liquidity requirements. Actual performance may not be consistent with the respective investment strategies. Investment risks and returns are measured and monitored on an ongoing basis through annual liability measurements and investment portfolio reviews to determine whether the asset allocation targets continue to represent an appropriate balance of expected risk and reward.
The following table provides the fair values of the pension plan assets at December 31, 20202022 by asset category:
Fair Value MeasurementsFair Value Measurements
Asset Category (a)Asset Category (a)Total
Quoted Prices in
Active Markets for
Identical Assets
(Level 1)
Significant
Observable
Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
Asset Category (a)Total
Quoted Prices in
Active Markets for
Identical Assets
(Level 1)
Significant
Observable
Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
CashCash$582 $582 Cash$769 $769 — — 
Money market fundsMoney market funds12 12 Money market funds13 13 — — 
Equity securities:Equity securities:Equity securities:
Managed volatility (b)Managed volatility (b)85,974 85,974 Managed volatility (b)46,721 46,721 — — 
U.S. small/mid-cap equity (c)U.S. small/mid-cap equity (c)11,780 11,780 U.S. small/mid-cap equity (c)6,054 6,054 — — 
World equity (excluding U.S.) (d)World equity (excluding U.S.) (d)59,467 59,467 World equity (excluding U.S.) (d)28,159 28,159 — — 
Common equity securities – Teleflex Incorporated29,592 29,592 
Fixed income securities:Fixed income securities:Fixed income securities:
Intermediate duration fund (e)Intermediate duration fund (e)63,376 63,376 Intermediate duration fund (e)105,865 105,865 — — 
Long duration bond fund (f)Long duration bond fund (f)98,996 98,996 Long duration bond fund (f)87,018 87,018 — — 
Corporate bond fund (g)Corporate bond fund (g)13,469 13,469 Corporate bond fund (g)6,092 6,092 — — 
Emerging markets debt fund (i)(h)Emerging markets debt fund (i)(h)11,412 11,412 Emerging markets debt fund (i)(h)6,284 6,284 — — 
Corporate, government and foreign bondsCorporate, government and foreign bonds35,582 35,582 Corporate, government and foreign bonds58,572 — $58,572 — 
Absolute return credit fund (i)Absolute return credit fund (i)427 — 427 — 
Asset backed – home loansAsset backed – home loans261 $261 Asset backed – home loans153 — 153 — 
Other types of investments:Other types of investments:Other types of investments:
Structured credit (j)Structured credit (j)29 29 — 
Multi asset funds (j)8,890 4,057 4,833 
Contract with insurance company (k)Contract with insurance company (k)10,485 $10,485 Contract with insurance company (k)11,114 — — $11,114 
Other
Total investments at fair valueTotal investments at fair value$429,882 $414,299 $5,094 $10,489 Total investments at fair value$357,270 $287,004 $59,152 $11,114 
Investments measured at net asset value (l)27,744 
TotalTotal$457,626 Total$357,270 





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TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

The following table provides the fair values of the pension plan assets at December 31, 20192021 by asset category:
Fair Value Measurements Fair Value Measurements
Asset Category (a)Asset Category (a)Total
Quoted Prices in
Active Markets for
Identical Assets
(Level 1)
Significant
Observable
Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
Asset Category (a)Total
Quoted Prices in
Active Markets for
Identical Assets
(Level 1)
Significant
Observable
Inputs
(Level 2)
Significant
Unobservable
Inputs
(Level 3)
CashCash$650 $650 Cash$923 $923 — — 
Money market fundsMoney market fundsMoney market funds— — 
Equity securities:Equity securities:Equity securities:
Managed volatility (b)Managed volatility (b)72,334 72,334 Managed volatility (b)57,252 57,252 — — 
U.S. small/mid-cap equity (c)U.S. small/mid-cap equity (c)10,014 10,014 U.S. small/mid-cap equity (c)7,532 7,532 — — 
World equity (excluding U.S.) (d)World equity (excluding U.S.) (d)48,285 48,285 World equity (excluding U.S.) (d)34,287 34,287 — — 
Common equity securities – Teleflex Incorporated38,359 38,359 
Fixed income securities:Fixed income securities:Fixed income securities:
Intermediate duration fund (e)Intermediate duration fund (e)38,500 38,500 Intermediate duration fund (e)101,363 101,363 — — 
Long duration bond fund (f)Long duration bond fund (f)107,143 107,143 Long duration bond fund (f)171,919 171,919 — — 
Corporate bond fund (g)Corporate bond fund (g)13,107 13,107 Corporate bond fund (g)7,607 7,607 — — 
Global credit fund (h)929 929 
Emerging markets debt fund (i)(h)Emerging markets debt fund (i)(h)9,974 9,974 Emerging markets debt fund (i)(h)7,605 7,605 — — 
Corporate, government and foreign bondsCorporate, government and foreign bonds29,714 29,714 Corporate, government and foreign bonds50,599 50,599 — — 
Absolute return credit fund (i)Absolute return credit fund (i)671 — $671 — 
Asset backed – home loansAsset backed – home loans316 $316 Asset backed – home loans208 — 208 — 
Other types of investments:Other types of investments:Other types of investments:
Multi asset funds (j)8,246 4,759 3,487 
Contract with insurance company (k)Contract with insurance company (k)9,849 $9,849 Contract with insurance company (k)19,130 — — $19,130 
OtherOtherOther— — 
Total investments at fair valueTotal investments at fair value$387,430 $373,773 $3,803 $9,854 Total investments at fair value$459,105 $439,093 $879 $19,133 
Investments measured at Net asset value (l)Investments measured at Net asset value (l)35,870 Investments measured at Net asset value (l)10,688 
TotalTotal$423,300 Total$469,793 
a.(a)Information on asset categories described in notes (b)-(k)(l) is derived from prospectuses and other material provided by the respective funds comprising the respective asset categories.
b.(b)This category comprises mutual funds that invest in securities of U.S. and non-U.S. companies of all capitalization ranges that exhibit relatively low volatility.
c.(c)This category comprises a mutual fund that invests at least 80% of its net assets in equity securities of small and mid-sized companies. The fund invests in common stocks or exchange traded funds holding common stock of U.S. companies with market capitalizations in the range of companies in the Russell 2500 Index.
d.(d)This category comprises a mutual fund that invests at least 80% of its net assets in equity securities of foreign companies. These securities may include common stocks, preferred stocks, warrants, exchange traded funds based on an international equity index, derivative instruments whose value is based on an international equity index and derivative instruments whose value is based on an underlying equity security or a basket of equity securities. The fund invests in securities of foreign issuers located in developed and emerging market countries. However, the fund will not invest more than 35% of its assets in the common stocks or other equity securities of issuers located in emerging market countries.
e.(e)This category comprises a mutual fund that invests in instruments or derivatives having economic characteristics similar to fixed income securities. The fund invests in investment grade fixed income instruments, including U.S. and foreign corporate obligations, fixed income securities issued by sovereigns or agencies in both developed and emerging foreign markets, debt obligations issued by governments or other municipalities, and securities issued or guaranteed by the U.S. Government and its agencies. The fund will seek to maintain an effective average duration between three and ten years, and uses derivative instruments, including interest rate swap agreements and credit default swaps, for the purpose of managing the overall duration and yield curve exposure of the Fund’s portfolio of fixed income securities.
f.(f)This category comprises a mutual fund that invests in instruments or derivatives having economic characteristics similar to fixed income securities. The fund invests in investment grade fixed income instruments, including securities issued or guaranteed by the U.S. Government and its agencies and instrumentalities, corporate bonds, asset-backed securities, exchange traded funds, mortgage-backed securities and collateralized mortgage-backed securities. The fund invests primarily in long duration government and corporate fixed income securities, and uses derivative instruments, including
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TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

interest rate swap agreements and Treasury futures contracts, for the purpose of managing the overall duration and yield curve exposure of the Fund’s portfolio of fixed income securities.
g.(g)This category comprises funds that invest primarily in higher-yielding fixed income securities, including corporate bonds and debentures, convertible and preferred securities and zero coupon obligations.
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h.
This category comprises a fund that invests primarily in a range of debt securities, including those issued by governments, institutions, or companies from a number of countries.
i.(h)This category comprises a mutual fund that invests at least 80% of its net assets in fixed income securities of emerging market issuers, primarily in U.S. dollar-denominated debt of foreign governments, government-related and corporate issuers in emerging market countries and entities organized to restructure the debt of those issuers.
j.(i)This category comprises fundsa mutual fund that may investinvests primarily in equities,investment grade bonds or derivatives.and similar fixed income and floating rate securities.
k.(j)This category comprises a fund that invests primarily in collateralized debt obligations and other structured credit vehicles and may include fixed income securities, loan participations, credit-linked notes, medium-term notes, pooled investment vehicles and derivative instruments.
(k)This category comprises the asset established out of an agreement to purchase a bulk-annuity policy from an insurer to fully cover the liabilities for members of the pension plan. The asset value is based on the fair value of the contract as determined by the insurance company using inputs that are not observable.
l.(l)This category comprises pooled institutional investments, primarily collective investment trusts. These funds are not listed on an exchange or traded in an active market and these investments are valued using their net asset value, which is generally based on the underlying asset values of the pooled investments held in the trusts. This category comprises the following funds:
a fund that invests primarily in collateralized debt obligations and other structured credit vehicles and may include fixed income securities, loan participations, credit-linked notes, medium-term notes, pooled investment vehicles and derivative instruments.
a hedge fund that invests in various other hedge funds.
funds that invest in underlying funds that acquire, manage, and dispose of real estate properties, with a focus on properties in the U.S. and the UK markets.
Our contributions to U.S. and foreign pension plans during 20212023 are expected to be approximately $12.7$1.4 million. Contributions to postretirement healthcare plans during 20212023 are expected to be approximately $3.1$2.2 million.
The following table provides information about the expected benefit payments under its U.S. and foreign plans for each of the five succeeding years and the aggregate of the five years thereafter, net of the annual average Medicare Part D subsidy of approximately $0.1 million:
PensionOther BenefitsPensionOther Benefits
2021$22,527 $3,123 
202222,997 2,996 
2023202323,433 2,864 2023$23,081 $2,174 
2024202424,018 2,583 202423,445 2,014 
2025202524,354 2,481 202523,934 1,986 
Years 2026 — 2030128,246 8,622 
2026202624,564 1,783 
2027202724,940 1,576 
Years 2028 — 2032Years 2028 — 2032127,978 6,509 
We maintain a number of defined contribution savings plans covering eligible U.S. and non-U.S. employees. We partially match employee contributions. Costs related to these plans were $24.3 million, $23.2 million and $21.7 million $17.5 millionfor 2022, 2021 and $15.6 million for 2020, 2019 and 2018, respectively.
 
Note 17 — Commitments and contingent liabilities
Environmental: We are subject to contingencies as a result of environmental laws and regulations that in the future may require us to take further action to correct the effects on the environment of prior disposal practices or releases of chemical or petroleum substances by us or other parties. Much of this liability results from the U.S. Comprehensive Environmental Response, Compensation and Liability Act, often referred to as Superfund, the U.S. Resource Conservation and Recovery Act and similar state laws. These laws require us to undertake certain investigative and remedial activities at sites where we conduct or once conducted operations or at sites where Company-generated waste was disposed.
Remediation activities vary substantially in duration and cost from site to site. The nature of these activities, and their associated costs, depend on the mix of unique site characteristics, evolving remediation technologies, the regulatory agencies involved and their enforcement policies, as well as the presence or absence of other potentially responsible parties. At December 31, 20202022 and 2019,2021, we have recorded $1.6$2.5 million and $0.7$2.0 million, respectively, in accrued liabilities and $5.2$3.2 million and $6.2$4.1 million, respectively in other liabilities relating to these matters. Considerable uncertainty exists with respect to these liabilities, and if adverse changes in circumstances occur, potential liability may exceed the amount accrued as of December 31, 2020.2022. The time frame over which the accrued amounts may be paid out, based on past history, is estimated to be 10-15 years.
F-39

TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Litigation:Legal matters: We are a party to various lawsuits and claims arising in the normal course of business. These lawsuits and claims include actions involving product liability, intellectual property, employment, environmental and other matters. As of December 31, 20202022 and 2019,2021, we have recorded accrued liabilities of $0.3$0.5 million and $0.4$0.2 million, respectively, in connection with such contingencies, representing our best estimate of the cost within the range of estimated possible losses that will be incurred to resolve these matters.
On February 17, 2021, representativesIn August 2022, the U.S. Department of Justice through the United States Attorney’s Office for the Northern District of Georgia (collectively, the “DOJ”) closed the Civil Investigative Demand (a “CID”) of one of our subsidiaries, NeoTract, Inc., under the civil False Claims Act, 31 U.S.C. §3729. The CID, which began in 2020, related to the DOJ’s investigation of a single NeoTract customer and certain rebate programs offered to that customer in addition to communications and activities occurring both prior to our acquisition of NeoTract in October 2017 and thereafter. As part of the selling shareholders from whom we acquired Essential Medical, Inc., filed suit on behalf of such shareholders ininvestigation the Court of Chancery of the State of Delaware alleging, among other things, that we breached the merger agreement relating to the acquisition in connection with activities relating to the achievement of revenue-based milestone goals under the agreement. The suit seeks money damages in the amount of $66.9 million plus interest. We are assessing our response to this action, but believe that the claims lack merit, and intend to defend ourselves vigorously.DOJ also opened an investigation into NeoTract’s operations broadly.
Based on information currently available, advice of counsel, established reserves and other resources, we do not believe that the outcome of any outstanding litigation and claims is likely to be, individually or in the aggregate, material to our business, financial condition, results of operations or liquidity. However, in the event of unexpected further developments, it is possible that the ultimate resolution of these matters, or other similar matters, if unfavorable, may be materially adverse to our business, financial condition, results of operations or liquidity. Legal costs such as outside counsel fees and expenses are charged to selling, general and administrative expenses in the period incurred.
Other: We have been subject to an ongoing investigation by the Chinese authorities related to a technical error regarding our country of origin designation for certain products we imported into China. TheHad the error not been made, we would have resulted inbeen obligated to make increased tariff payments in late 2018 through 2020. We have accrued the estimated increase in tariffs as well as related interest expense for the periods in question.first quarter of 2021. In addition to the tariffs and related interest, the Chinese authorities may impose a penalty for the unpaid tariffs.
To date, we have remitted payment for the requested amounts of the increased tariffs, and we believe this to be the final action required to close the case. However, we have not received confirmation from the Chinese authorities that the case is closed and as a result, it remains possible that they may request payment for penalties and interest in the future. We believe the range of penalties iscould be between 30% and 200% of the related unpaidincreased tariff amount or between $3.0$3 million and $20.3$20 million. We do not have a best estimate of the penalties that may be assessed at this time. Accordingly, as prescribed by GAAP, we have recorded $3.0 million as low end of the range described above.
In June 2020, we began producing documents2015, the Italian parliament enacted legislation that, among other things, imposed a “payback” measure on medical device companies that supply goods and informationservices to the Italian National Healthcare System. Under the measure, companies are required to make payments to the Italian government if medical device expenditures in a given year exceed regional expenditure ceilings established for that year. The payment amounts are calculated based on the amount by which the regional ceilings for the given year were exceeded. Considerable uncertainty exists related to the enforceability of and implementation process for the payback law. In response to a Civil Investigative Demand (a “CID”) received in March 2020decrees issued by onethe Italian Ministry of our subsidiaries, NeoTract, fromHealth, the U.S. Department of Justice through the United States Attorney’s Office for the Northern District of Georgia (collectively, the “DOJ”). The CID relatesvarious Italian regions issued invoices to the DOJ’s investigation of a single NeoTract customer, requires the production of documents and information pertaining to communications with, and certain rebate programs offered to, that customer and pertains to communications and activities occurring both prior to our acquisition of NeoTract in October 2017 and thereafter. In July 2020, the DOJ advised us that it had opened an investigationmedical device companies, including Teleflex, under the civil False Claims Act, 31 U.S.C. §3729,payback measure in the fourth quarter of 2022 seeking payment with respect to NeoTract’s operations broadly in addition toexcess expenditures for the customer investigation.
We maintain policiesyears 2015 through 2018. Following the issuance of the invoices, we and procedures to promote compliancenumerous other medical device companies filed appeals with the Anti-Kickback Statute, False Claims Acts and other applicable laws and regulations and intend to provide information sought byItalian administrative courts challenging the government. We cannot at this time reasonably predict, however,enforceability of the ultimate scope or outcomepayback measure, which appeals remain pending. As of December 31, 2022, our reserve for this matter including whether an investigation may raise other compliance issuesis $10.9 million, $2.6 million of interest, including those beyondwhich was recorded as a reduction of revenue for 2022. If the scope described above or how any such issues mightpayback was to ultimately be resolved. We also cannot at this time reasonablyenforced in its existing form, we estimate any potential liabilities or penalty, if any, that may arise from this matter, which could have a material adverse effect onwe would be required to remit payments in excess of our resultscurrent reserve of operations and financial condition.up to $23.0 million.

Note 18 — Business segments and other information
An operating segment is a component (a) that engages in business activities from which it may earn revenues and incur expenses, (b) whose operating results are regularly reviewed by the chief operating decision maker to make decisions about resources to be allocated to the segment and to assess its performance, and (c) for which discrete financial information is available. We do not evaluate our operating segments using discrete asset information.
We have 4four reportable segments: Americas, EMEA (Europe, the Middle East and Africa), Asia (Asia Pacific) and OEM (Original Equipment Manufacturer and Development Services).
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TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Our reportable segments, other than the OEM segment, design, manufacture and distribute medical devices primarily used in critical care and surgical applications and generally serve two end-markets: hospitals and
F-40


healthcare providers, and home health. The products of these segments are most widely used in the acute care setting for a range of diagnostic and therapeutic procedures and in general and specialty surgical applications. The OEM segment designs, manufactures and supplies devices and instruments for other medical device manufacturers.
The following tables present our segment results for the years ended December 31, 2020, 20192022, 2021 and 2018:2020:
Year Ended December 31, Year Ended December 31,
202020192018 202220212020
AmericasAmericas$1,465,035 $1,492,274 $1,351,699 Americas$1,653,724 $1,659,309 $1,465,035 
EMEAEMEA584,859 588,043 603,813 EMEA558,373 606,807 584,859 
AsiaAsia267,016 294,328 286,895 Asia306,320 297,766 267,016 
OEMOEM220,246 220,717 205,976 OEM272,624 245,681 220,246 
Net revenuesNet revenues$2,537,156 $2,595,362 $2,448,383 Net revenues$2,791,041 $2,809,563 $2,537,156 
Year Ended December 31,
202220212020
Americas$452,030 $424,225 $401,391 
EMEA42,465 94,865 81,348 
Asia82,786 84,648 51,238 
OEM65,379 56,210 44,852 
Total segment operating profit (1)
642,660 659,948 578,829 
Unallocated expenses (2)
(142,935)(31,853)(155,761)
Income from continuing operations before interest, loss on extinguishment of debt and taxes$499,725 $628,095 $423,068 

(1
Year Ended December 31,
202020192018
Americas$401,391 $319,933 $255,798 
EMEA81,348 94,424 106,090 
Asia51,238 73,090 78,135 
OEM44,852 57,994 50,294 
Total segment operating profit (1)
578,829 545,441 490,317 
Unallocated expenses (2)
(155,761)(118,187)(168,613)
Income from continuing operations before interest, loss on extinguishment of debt and taxes$423,068 $427,254 $321,704 
(1)) Segment operating profit includes segment net revenues from external customers reduced by its standard cost of goods sold, adjusted for fixed manufacturing cost absorption variances, selling, general and administrative expenses, research and development expenses and an allocation of corporate expenses. CorporateCommencing on January 1, 2022, all corporate expenses are allocated amongst the segments in proportion to the respective amounts of net revenues. The change in the measure of segment operating profit does not impact period over period comparability because the change was immaterial. For the year ended December 31, 2021, corporate expenses were allocated among the segments in proportion to the respective amounts of one of several items (such as sales, numbers of employees, and amount of time spent), depending on the category of expense involved.
(2) Unallocated expenses primarily include manufacturing variances with the exception ofother than fixed manufacturing cost absorption variances, restructuring and impairment charges and gain on sale of assets.business.
Year Ended December 31, Year Ended December 31,
202020192018 202220212020
AmericasAmericas$151,111 $153,419 $146,016 Americas$162,898 $164,102 $151,111 
EMEAEMEA47,012 44,328 47,171 EMEA39,957 45,022 47,012 
AsiaAsia13,594 14,072 12,917 Asia10,107 11,140 13,594 
OEMOEM15,535 6,550 8,610 OEM17,628 17,098 15,535 
Consolidated depreciation and amortizationConsolidated depreciation and amortization$227,252 $218,369 $214,714 Consolidated depreciation and amortization$230,590 $237,362 $227,252 
F-41

TELEFLEX INCORPORATED
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Geographic data
The following tables provide total net revenues and total net property, plant and equipment by geographic region for the years ended December 31, 2022, 2021 and 2020 and as of December 31, 2020, 20192022 and 2018:2021, respectively.
Year Ended December 31,
202020192018
Net revenues (based on selling location):
U.S.$1,567,144 $1,606,248 $1,449,426 
Europe646,577 652,069 671,264 
Asia Pacific230,267 241,278 234,090 
All other93,168 95,767 93,603 
$2,537,156 $2,595,362 $2,448,383 
Net property, plant and equipment:
U.S.$234,186 $228,173 $258,415 
Malaysia71,760 53,406 51,952 
Ireland52,373 40,151 41,223 
All other115,593 108,989 81,176 
$473,912 $430,719 $432,766 
F-42


QUARTERLY DATA (UNAUDITED)
First
Quarter
Second
Quarter
Third
Quarter
Fourth
Quarter
(Dollars in thousands, except per share)
2020
Net revenues$630,642 $567,034 $628,301 $711,179 
Gross profit333,624 278,372 329,324 383,554 
Income from continuing operations before interest,loss on extinguishment of debt and taxes157,086 38,810 132,092 95,080 
Income from continuing operations131,152 11,443 116,605 76,601 
(Loss) income from discontinued operations(2)13 (18)(470)
Net income131,150 11,456 116,587 76,131 
Earnings per share — basic(1):
Income from continuing operations$2.83 $0.25 $2.51 $1.64 
Income from discontinued operations(0.01)
Net income$2.83 $0.25 $2.51 $1.63 
Earnings per share — diluted(1):
Income from continuing operations$2.78 $0.24 $2.46 $1.62 
Income from discontinued operations(0.01)
Net income$2.78 $0.24 $2.46 $1.61 
2019
Net revenues$613,584 $652,507 $648,319 $680,952 
Gross profit(2)
323,970 352,238 355,075 377,722 
Income from continuing operations before interest,loss on extinguishment of debt and taxes75,243 107,458 117,621 126,932 
Income from continuing operations41,918 83,328 228,929 107,806 
(Loss) income from discontinued operations(1,021)47 459 
Net income40,897 83,375 228,929 108,265 
Earnings per share — basic(1):
Income from continuing operations$0.91 $1.80 $4.95 $2.33 
(Loss) income from discontinued operations(0.02)0.01 0.01 
Net income$0.89 $1.81 $4.95 $2.34 
Earnings per share — diluted(1):
Income from continuing operations$0.89 $1.77 $4.85 $2.28 
(Loss) income from discontinued operations(0.02)0.01 
Net income$0.87 $1.77 $4.85 $2.29 

(1)Each quarter is calculated as a discrete period; the sum of the four quarters may not equal the calculated full year amount.
(2)For the three months ended March 31, 2019, June 30, 2019, September 29, 2019, and December 31, 2019 we reclassified intangible asset amortization expense of $20.8 million, $20.7 million, $20.6 million and $20.5 million, respectively, from selling, general and administrative expenses to cost of goods sold.
Year Ended December 31,
202220212020
Net revenues (based on selling location):
U.S.$1,786,467 $1,769,488 $1,567,144 
Europe622,343 665,000 646,577 
Asia Pacific270,749 263,022 230,267 
All other111,482 112,053 93,168 
$2,791,041 $2,809,563 $2,537,156 
As of December 31,
Net property, plant and equipment:20222021
U.S.$193,618 $206,876 
Malaysia73,441 72,541 
Mexico82,334 69,471 
All other97,812 94,870 
$447,205 $443,758 

55F-42


TELEFLEX INCORPORATED
SCHEDULE II — VALUATION AND QUALIFYING ACCOUNTS
(Dollars in thousands)
ALLOWANCE FOR DOUBTFUL ACCOUNTS
Balance at
Beginning of
Year
Additions
Charged to
Income
Accounts
Receivable
Write-offs
Translation
and Other
Balance at
End of
Year
December 31, 2020$9,055 $3,798 $(1,336)$1,358 $12,875 
December 31, 2019$9,348 $1,680 $(1,739)$(234)$9,055 
December 31, 2018$10,255 $2,521 $(2,601)$(827)$9,348 
Balance at
Beginning of
Year
(Reversals) additions
Charged to
Income
Accounts
Receivable
Write-offs
Translation
and Other
Balance at
End of
Year
December 31, 2022$10,799 $(786)$(1,750)$299 $8,562 
December 31, 2021$12,875 $1,542 $(3,001)$(617)$10,799 
December 31, 2020$9,055 $3,798 $(1,336)$1,358 $12,875 
DEFERRED TAX ASSET VALUATION ALLOWANCE
Balance at
Beginning of Year
Additions
Charged to
Expense
Reductions
Credited to
Expense
Translation
and Other
Balance at
End of Year
December 31, 2020$119,233 $30,640 $(59)$5,194 $155,008 
December 31, 2019$143,971 $31,564 $(55,797)$(505)$119,233 
December 31, 2018$104,799 $43,361 $(2,871)$(1,318)$143,971 
Balance at
Beginning of Year
Additions
Charged to
Expense
Reductions
Credited to
Expense
Translation
and Other
Balance at
End of Year
December 31, 2022$143,177 $8,489 $(59,520)$(615)$91,531 
December 31, 2021$155,008 $7,770 $(15,384)$(4,217)$143,177 
December 31, 2020$119,233 $30,640 $(59)$5,194 $155,008 

56F-43