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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended SeptemberJune 30, 20212022
OR
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
Commission File No. 1-11083
BOSTON SCIENTIFIC CORPORATION
(Exact name of registrant as specified in its charter)
Delaware04-2695240
(State or other jurisdiction of incorporation or organization)(I.R.S. Employer Identification No.)
    300 Boston Scientific Way, Marlborough, Massachusetts                    01752-1234
        (Address of Principal Executive Offices)                         (Zip Code)
508 683-4000
(Registrant’s telephone number, including area code)
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 $0.01 per shareBSXNew York Stock Exchange
0.625% Senior Notes due 2027BSX27New York Stock Exchange
5.50% Mandatory Convertible Preferred Stock, Series A, par value $0.01 per shareBSX PR ANew York Stock Exchange
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 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 (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes 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 filerAccelerated filer
Non-accelerated filerSmaller 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 is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes No
The number of shares outstanding of Common Stock, $0.01 par value per share, as of OctoberJuly 29, 20212022 was 1,424,992,477.1,431,614,313.


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PART I
FINANCIAL INFORMATION

ITEM 1. CONSOLIDATED FINANCIAL STATEMENTS

BOSTON SCIENTIFIC CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS (UNAUDITED)

Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
June 30,
Six Months Ended
June 30,
(in millions, except per share data)(in millions, except per share data)2021202020212020(in millions, except per share data)2022202120222021
Net salesNet sales$2,932 $2,659 $8,761 $7,204 Net sales$3,244 $3,077 $6,270 $5,829 
Cost of products soldCost of products sold900 869 2,739 2,465 Cost of products sold1,011 945 1,966 1,839 
Gross profitGross profit2,032 1,790 6,022 4,740 Gross profit2,233 2,132 4,304 3,990 
Operating expenses:Operating expenses:Operating expenses:
Selling, general and administrative expensesSelling, general and administrative expenses1,066 984 3,206 2,760 Selling, general and administrative expenses1,165 1,121 2,225 2,139 
Research and development expensesResearch and development expenses310 315 884 857 Research and development expenses335 298 654 574 
Royalty expenseRoyalty expense14 12 38 32 Royalty expense11 12 23 24 
Amortization expenseAmortization expense184 197 549 595 Amortization expense204 180 402 365 
Intangible asset impairment chargesIntangible asset impairment charges128 219 173 452 Intangible asset impairment charges45 45 
Contingent consideration net expense (benefit)Contingent consideration net expense (benefit)(26)(117)(102)Contingent consideration net expense (benefit)36 (85)48 (91)
Restructuring net charges (credits)Restructuring net charges (credits)18 16 Restructuring net charges (credits)11 14 
Litigation-related net charges (credits)Litigation-related net charges (credits)— 260 302 260 Litigation-related net charges (credits)42 298 42 302 
Gain on disposal of businesses and assetsGain on disposal of businesses and assets(40)— (48)— Gain on disposal of businesses and assets— (2)— (9)
1,645 1,995 5,003 4,870  1,810 1,870 3,415 3,358 
Operating income (loss)Operating income (loss)387 (205)1,019 (130)Operating income (loss)423 262 889 632 
Other income (expense):Other income (expense):Other income (expense):
Interest expenseInterest expense(86)(86)(254)(265)Interest expense(64)(86)(343)(168)
Other, netOther, net181 64 192 Other, net(14)(26)(46)11 
Income (loss) before income taxesIncome (loss) before income taxes483 (227)957 (386)Income (loss) before income taxes345 149 501 474 
Income tax expense (benefit)Income tax expense (benefit)64 (72)10 (94)Income tax expense (benefit)85 (37)131 (53)
Net income (loss)Net income (loss)419 (155)946 (292)Net income (loss)260 186 370 527 
Preferred stock dividendsPreferred stock dividends(14)(14)(42)(19)Preferred stock dividends(14)(14)(28)(28)
Net income (loss) available to common stockholdersNet income (loss) available to common stockholders$405 $(169)$905 $(311)Net income (loss) available to common stockholders$246 $172 $342 $500 
Net income (loss) per common share — basicNet income (loss) per common share — basic$0.28 $(0.12)$0.64 $(0.22)Net income (loss) per common share — basic$0.17 $0.12 $0.24 $0.35 
Net income (loss) per common share — assuming dilutionNet income (loss) per common share — assuming dilution$0.28 $(0.12)$0.63 $(0.22)Net income (loss) per common share — assuming dilution$0.17 $0.12 $0.24 $0.35 
Weighted-average shares outstandingWeighted-average shares outstandingWeighted-average shares outstanding
BasicBasic1,423.8 1,430.9 1,421.3 1,413.0 Basic1,429.7 1,421.3 1,428.8 1,420.0 
Assuming dilutionAssuming dilution1,435.6 1,430.9 1,433.0 1,413.0 Assuming dilution1,437.8 1,432.5 1,438.1 1,431.7 




SeeRefer to notes to the unaudited consolidated financial statements. Amounts may not foot due to rounding.
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BOSTON SCIENTIFIC CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (UNAUDITED)

Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
June 30,
Six Months Ended
June 30,
(in millions)(in millions)2021202020212020(in millions)2022202120222021
Net income (loss)Net income (loss)$419 $(155)$946 $(292)Net income (loss)$260 $186 $370 $527 
Other comprehensive income (loss), net of tax:Other comprehensive income (loss), net of tax:Other comprehensive income (loss), net of tax:
Foreign currency translation adjustmentForeign currency translation adjustment(49)84 (130)(104)Foreign currency translation adjustment77 13 (81)
Net change in derivative financial instrumentsNet change in derivative financial instruments50 (64)161 (15)Net change in derivative financial instruments134 (18)157 111 
Net change in defined benefit pensions and other itemsNet change in defined benefit pensions and other items— — — Net change in defined benefit pensions and other items
Total other comprehensive income (loss)Total other comprehensive income (loss)20 31 (119)Total other comprehensive income (loss)211 (16)170 30 
Total comprehensive income (loss)Total comprehensive income (loss)$420 $(135)$978 $(411)Total comprehensive income (loss)$471 $170 $540 $558 









































SeeRefer to notes to the unaudited consolidated financial statements. Amounts may not foot due to rounding.
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BOSTON SCIENTIFIC CORPORATION AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS (UNAUDITED)
As of As of
(in millions, except share and per share data)(in millions, except share and per share data)September 30, 2021December 31, 2020(in millions, except share and per share data)June 30, 2022December 31, 2021
(unaudited) 
ASSETSASSETS  ASSETS  
Current assets:Current assets:  Current assets:  
Cash and cash equivalentsCash and cash equivalents$1,947 $1,734 Cash and cash equivalents$276 $1,925 
Trade accounts receivable, netTrade accounts receivable, net1,669 1,531 Trade accounts receivable, net1,917 1,778 
InventoriesInventories1,603 1,351 Inventories1,752 1,610 
Prepaid income taxesPrepaid income taxes217 194 Prepaid income taxes264 205 
Assets held for sale— 1,133 
Other current assetsOther current assets792 751 Other current assets874 799 
Total current assetsTotal current assets6,229 6,694 Total current assets5,083 6,317 
Property, plant and equipment, netProperty, plant and equipment, net2,109 2,084 Property, plant and equipment, net2,246 2,252 
GoodwillGoodwill11,820 9,951 Goodwill12,883 11,988 
Other intangible assets, netOther intangible assets, net6,227 5,917 Other intangible assets, net6,349 6,121 
Deferred tax assetsDeferred tax assets4,049 4,210 Deferred tax assets4,059 4,142 
Other long-term assetsOther long-term assets1,444 1,921 Other long-term assets1,569 1,410 
TOTAL ASSETSTOTAL ASSETS$31,877 $30,777 TOTAL ASSETS$32,189 $32,229 
LIABILITIES AND STOCKHOLDERS’ EQUITYLIABILITIES AND STOCKHOLDERS’ EQUITY  LIABILITIES AND STOCKHOLDERS’ EQUITY  
Current liabilities:Current liabilities:  Current liabilities:  
Current debt obligationsCurrent debt obligations$261 $13 Current debt obligations$170 $261 
Accounts payableAccounts payable674 513 Accounts payable732 794 
Accrued expensesAccrued expenses2,418 2,197 Accrued expenses2,197 2,436 
Other current liabilitiesOther current liabilities669 958 Other current liabilities784 783 
Total current liabilitiesTotal current liabilities4,022 3,681 Total current liabilities3,883 4,274 
Long-term debtLong-term debt8,824 9,130 Long-term debt8,802 8,804 
Deferred income taxesDeferred income taxes274 330 Deferred income taxes265 310 
Other long-term liabilitiesOther long-term liabilities2,296 2,309 Other long-term liabilities1,988 2,220 
Commitments and contingenciesCommitments and contingencies00Commitments and contingencies00
Stockholders’ equityStockholders’ equity  Stockholders’ equity  
Preferred stock, $0.01 par value - authorized 50,000,000 shares - issued 10,062,500 shares as of September 30, 2021 and December 31, 2020— — 
Common stock, $0.01 par value - authorized 2,000,000,000 shares - issued 1,688,023,638 shares as of September 30, 2021 and 1,679,911,918 shares as of December 31, 202017 17 
Treasury stock, at cost - 263,289,848 shares as of September 30, 2021 and December 31, 2020(2,251)(2,251)
Preferred stock, $0.01 par value - authorized 50,000,000 shares - issued 10,062,500 shares as of June 30, 2022 and December 31, 2021Preferred stock, $0.01 par value - authorized 50,000,000 shares - issued 10,062,500 shares as of June 30, 2022 and December 31, 2021— — 
Common stock, $0.01 par value - authorized 2,000,000,000 shares - issued 1,693,192,785 shares as of June 30, 2022 and 1,688,810,052 shares as of December 31, 2021Common stock, $0.01 par value - authorized 2,000,000,000 shares - issued 1,693,192,785 shares as of June 30, 2022 and 1,688,810,052 shares as of December 31, 202117 17 
Treasury stock, at cost - 263,289,848 shares as of June 30, 2022 and December 31, 2021Treasury stock, at cost - 263,289,848 shares as of June 30, 2022 and December 31, 2021(2,251)(2,251)
Additional paid-in capitalAdditional paid-in capital19,930 19,732 Additional paid-in capital20,103 19,986 
Accumulated deficitAccumulated deficit(1,473)(2,378)Accumulated deficit(1,050)(1,392)
Accumulated other comprehensive income (loss), net of taxAccumulated other comprehensive income (loss), net of tax238 207 Accumulated other comprehensive income (loss), net of tax433 263 
Total stockholders’ equityTotal stockholders’ equity16,462 15,326 Total stockholders’ equity17,251 16,622 
TOTAL LIABILITIES AND STOCKHOLDERS' EQUITYTOTAL LIABILITIES AND STOCKHOLDERS' EQUITY$31,877 $30,777 TOTAL LIABILITIES AND STOCKHOLDERS' EQUITY$32,189 $32,229 



SeeRefer to notes to the unaudited consolidated financial statements. Amounts may not foot due to rounding.
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BOSTON SCIENTIFIC CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (UNAUDITED)

Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
June 30,
Six Months Ended
June 30,
(in millions, except share data)(in millions, except share data)2021202020212020(in millions, except share data)2022202120222021
Preferred stock shares outstanding
Preferred stock shares issuedPreferred stock shares issued
Beginning Beginning10,062,500 10,062,500 10,062,500   Beginning10,062,500 10,062,500 10,062,500 10,062,500 
Preferred stock issuancePreferred stock issuance— — — 10,062,500 Preferred stock issuance— — — — 
Ending Ending10,062,500 10,062,500 10,062,500 10,062,500  Ending10,062,500 10,062,500 10,062,500 10,062,500 
Common stock shares outstanding
Common stock shares issuedCommon stock shares issued
Beginning Beginning1,685,006,608 1,676,753,566 1,679,911,918 1,642,488,911  Beginning1,692,828,987 1,683,861,226 1,688,810,052 1,679,911,918 
Common stock issuanceCommon stock issuance— — — 29,382,500 Common stock issuance— — — — 
Stock-based compensation3,017,030 2,674,643 8,111,720 7,556,798 
Impact of stock-based compensation plansImpact of stock-based compensation plans363,798 1,145,382 4,382,733 5,094,690 
Ending Ending1,688,023,638 1,679,428,209 1,688,023,638 1,679,428,209  Ending1,693,192,785 1,685,006,608 1,693,192,785 1,685,006,608 
Preferred stockPreferred stockPreferred stock
Beginning Beginning$ $ $ $  Beginning$ $ $ $ 
Preferred stock issuancePreferred stock issuance— — — — Preferred stock issuance— — — — 
Ending Ending $  $  Ending$ $  $ 
Common stockCommon stockCommon stock
Beginning Beginning$17 $17 $17 $16  Beginning$17 $17 $17 $17 
Common stock issuanceCommon stock issuance— — — — Common stock issuance— — — — 
Stock-based compensation— — — — 
Impact of stock-based compensation plansImpact of stock-based compensation plans— — — — 
Ending Ending$17 $17 $17 $17  Ending$17 $17 $17 $17 
Treasury StockTreasury StockTreasury Stock
BeginningBeginning$(2,251)$(1,717)$(2,251)$(1,717)Beginning$(2,251)$(2,251)$(2,251)$(2,251)
Repurchase of common stockRepurchase of common stock— — — — Repurchase of common stock— — — — 
EndingEnding$(2,251)$(1,717)$(2,251)$(1,717)Ending$(2,251)$(2,251)$(2,251)$(2,251)
Additional Paid-In CapitalAdditional Paid-In CapitalAdditional Paid-In Capital
BeginningBeginning$19,817 $19,590 $19,732 $17,561 Beginning$20,043 $19,750 $19,986 $19,732 
Preferred stock issuance— — — 975 
Common stock issuance— — — 975 
Stock-based compensation113 97 199 176 
Impact of stock-based compensation plansImpact of stock-based compensation plans60 66 117 85 
EndingEnding$19,930 $19,687 $19,930 $19,687 Ending$20,103 $19,817 $20,103 $19,817 
Accumulated DeficitAccumulated DeficitAccumulated Deficit
BeginningBeginning$(1,878)$(2,405)$(2,378)$(2,253)Beginning$(1,296)$(2,050)$(1,392)$(2,378)
Net income (loss)Net income (loss)419 (155)946 (292)Net income (loss)260 186 370 527 
Cumulative effect adjustment for adoption of ASU 2016-13— — — (10)
Preferred stock dividendsPreferred stock dividends(14)(14)(42)(19)Preferred stock dividends(14)(14)(28)(28)
EndingEnding$(1,473)$(2,574)$(1,473)$(2,574)Ending$(1,050)$(1,878)$(1,050)$(1,878)
Accumulated Other Comprehensive Income (Loss), Net of TaxAccumulated Other Comprehensive Income (Loss), Net of TaxAccumulated Other Comprehensive Income (Loss), Net of Tax
BeginningBeginning$237 $131 $207 $270 Beginning$222 $254 $263 $207 
Total other comprehensive income (loss)20 31 (119)
Changes in other comprehensive income (loss)Changes in other comprehensive income (loss)211 (16)170 30 
EndingEnding$238 $151 $238 $151 Ending$433 $237 $433 $237 
Total stockholders' equityTotal stockholders' equity16,462 15,564 16,462 15,564 Total stockholders' equity$17,251 $15,942 17,251 15,942 







SeeRefer to notes to the unaudited consolidated financial statements. Amounts may not foot due to rounding.
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BOSTON SCIENTIFIC CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED)
Nine Months Ended September 30,
(in millions)20212020
Net income (loss)$946 $(292)
Adjustments to reconcile net income (loss) to cash provided by (used for) operating activities
Gain on disposal of businesses and assets(48)— 
Depreciation and amortization803 834 
Deferred and prepaid income taxes(49)(13)
Stock-based compensation expense145 128 
Intangible asset impairment charges173 452 
Net loss (gain) on investments and notes receivable(208)(29)
Contingent consideration net expense (benefit)(117)(102)
Inventory step-up amortization15 42 
Foreign exchange (gain) loss17 13 
Other, net32 46 
Increase (decrease) in operating assets and liabilities, excluding purchase accounting:
Trade accounts receivable(131)242 
Inventories(315)(1)
Other assets(145)(119)
Accounts payable, accrued expenses and other liabilities275 (364)
Cash provided by (used for) operating activities1,392 835 
Purchases of property, plant and equipment(288)(217)
Proceeds from sale of property, plant and equipment10 
Payments for acquisitions of businesses, net of cash acquired(2,014)(3)
Proceeds from royalty rights62 66 
Payments for investments and acquisitions of certain technologies(51)(130)
Proceeds from sale of investments and disposition of certain assets329 — 
Proceeds from disposal of businesses801 15 
Proceeds from settlements of hedge contracts15 — 
Cash provided by (used for) investing activities(1,136)(264)
Payment of contingent consideration previously established in purchase accounting(14)(35)
Payments for royalty rights(85)(97)
Payments on short-term borrowings— (2,950)
Proceeds from short-term borrowings, net of debt issuance costs— 2,245 
Net increase (decrease) in commercial paper— (714)
Payments on borrowings from credit facilities— (1,919)
Proceeds from borrowings on credit facilities— 1,916 
Payments on long-term borrowings and debt extinguishment costs— (1,000)
Proceeds from long-term borrowings, net of debt issuance costs— 1,683 
Cash dividends paid on preferred stock(42)(14)
Net proceeds from issuance of preferred stock in connection with public offering— 975 
Net proceeds from issuance of common stock in connection with public offering— 975 
Cash used to net share settle employee equity awards(48)(59)
Proceeds from issuances of common stock pursuant to employee stock compensation and purchase plans102 107 
Cash provided by (used for) financing activities(87)1,112 
Effect of foreign exchange rates on cash(5)(8)
Net increase (decrease) in cash, cash equivalents, restricted cash and restricted cash equivalents164 1,675 
Cash, cash equivalents, restricted cash and restricted cash equivalents at beginning of period1,995 607 
Cash, cash equivalents, restricted cash and restricted cash equivalents at end of period$2,159 $2,282 

See
Six Months Ended June 30,
(in millions)20222021
Net income (loss)$370 $527 
Adjustments to reconcile net income (loss) to cash provided by (used for) operating activities
Gain on disposal of businesses and assets— (9)
Depreciation and amortization558 531 
Deferred and prepaid income taxes(93)(88)
Stock-based compensation expense107 94 
Goodwill and other intangible asset impairment charges45 
Net loss (gain) on investments and notes receivable36 (22)
Contingent consideration net expense (benefit)48 (91)
Inventory step-up amortization25 
Debt extinguishment costs194 — 
Other, net31 35 
Increase (decrease) in operating assets and liabilities, excluding purchase accounting:
Trade accounts receivable(162)(145)
Inventories(180)(100)
Other assets(244)(200)
Accounts payable, accrued expenses and other liabilities(449)340 
Cash provided by (used for) operating activities249 927 
Investing activities:  
Purchases of property, plant and equipment and internal use software(226)(181)
Proceeds from sale of property, plant and equipment
Payments for acquisitions of businesses, net of cash acquired(1,471)(706)
Proceeds from (payments for) investments and acquisitions of certain technologies(14)92 
Proceeds from disposal of certain businesses and assets801 
Proceeds from royalty rights36 43 
Proceeds from settlements of hedge contracts56 15 
Cash provided by (used for) investing activities(1,603)71 
Financing activities:  
Payment of contingent consideration previously established in purchase accounting(283)(14)
Payments for royalty rights(39)(42)
Payments on short-term borrowings(250)— 
Net increase (decrease) in commercial paper154 — 
Payments on long-term borrowings and debt extinguishment costs(3,184)— 
Proceeds from long-term borrowings, net of debt issuance costs3,270 — 
Cash dividends paid on preferred stock(28)(28)
Cash used to net share settle employee equity awards(47)(47)
Proceeds from issuances of common stock pursuant to employee stock compensation and purchase plans58 38 
Cash provided by (used for) financing activities(350)(93)
Effect of foreign exchange rates on cash(6)(2)
Net increase (decrease) in cash, cash equivalents, restricted cash and restricted cash equivalents(1,710)903 
Cash, cash equivalents, restricted cash and restricted cash equivalents at beginning of period2,168 1,995 
Cash, cash equivalents, restricted cash and restricted cash equivalents at end of period$458 $2,898 

Refer to notes to the unaudited consolidated financial statements. Amounts may not foot due to rounding.
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BOSTON SCIENTIFIC CORPORATION AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED)
(SUPPLEMENTAL INFORMATION)

Nine Months Ended September 30,Six Months Ended June 30,
(in millions)(in millions)20212020(in millions)20222021
Supplemental InformationSupplemental InformationSupplemental Information
Stock-based compensation expenseStock-based compensation expense$145 $128 Stock-based compensation expense$107 $94 
Fair value of contingent consideration recorded in purchase accountingFair value of contingent consideration recorded in purchase accounting384 — Fair value of contingent consideration recorded in purchase accounting— 221 
Non-cash impact of transferred royalty rightsNon-cash impact of transferred royalty rights(62)(66)Non-cash impact of transferred royalty rights(36)(43)

As of September 30,As of June 30,
Reconciliation to amounts in the unaudited consolidated balance sheets:20212020
Reconciliation to amounts within the unaudited consolidated balance sheets:Reconciliation to amounts within the unaudited consolidated balance sheets:20222021
Cash and cash equivalentsCash and cash equivalents$1,947 $2,022 Cash and cash equivalents$276 $2,675 
Restricted cash and restricted cash equivalents included in Other current assets
Restricted cash and restricted cash equivalents included in Other current assets
155 214 
Restricted cash and restricted cash equivalents included in Other current assets
132 167 
Restricted cash equivalents included in Other long-term assets
Restricted cash equivalents included in Other long-term assets
57 46 
Restricted cash equivalents included in Other long-term assets
50 57 
Cash, cash equivalents, restricted cash and restricted cash equivalents at end of periodCash, cash equivalents, restricted cash and restricted cash equivalents at end of period$2,159 $2,282 Cash, cash equivalents, restricted cash and restricted cash equivalents at end of period$458 $2,898 
























SeeRefer to notes to the unaudited consolidated financial statements. Amounts may not foot due to rounding.
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NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)

NOTE A – BASIS OF PRESENTATION

The accompanying unaudited consolidated financial statements of Boston Scientific Corporation have been prepared in accordance with accounting principles generally accepted in the United States (U.S. GAAP) and with the instructions to Form 10-Q and Article 10 of Regulation S-X, and they do not include all of the information and footnotes required by U.S. GAAP for complete financial statements. When used in this report, the terms, "we," "us," "our," and "the Company" mean Boston Scientific Corporation and its divisions and subsidiaries. In the opinion of management, all adjustments (consisting only of normal recurring adjustments) considered necessary for fair presentation have been included. Operating results for the three and ninesix months ended SeptemberJune 30, 20212022 are not necessarily indicative of the results that may be expected for the year ending December 31, 2021.2022. Accordingly, our unaudited consolidated financial statements and footnotes thereto should be read in conjunction with our audited consolidated financial statements and footnotes thereto included in Item 8 of our most recent Annual Report on Form 10-K.

In the first quarter of 2022, we reorganized our operational structure in order to strengthen our category leadership in the markets we serve and, in particular, benefit our Cardiology customers and patients. Following the reorganization, we have aggregated our core businesses into 2 reportable segments: MedSurg and Cardiovascular, each of which generates revenues from the sale of medical devices. We have revised prior periods to conform to the current year presentation.

Amounts reported in millions within this Quarterly Report on Form 10-Q are computed based on the amounts in thousands. As a result, the sum of the components may not equal the total amount reported in millions due to rounding. Certain columns and rows within tables may not add due to the use of rounded numbers. Percentages presented are calculated from the underlying unrounded amounts.

Subsequent Events
We evaluate events occurring after the date of our accompanying unaudited consolidated balance sheet for potential recognition or disclosure in our financial statements. Those items requiring recognition in the financial statements have been recorded and disclosed accordingly.
Those items requiring disclosure (non-recognized subsequent events) in the financial statements have been disclosed accordingly. Refer toNote B – Acquisitions, Divestitures and Strategic Investments, Note H – Commitments and Contingencies and Note I – Stockholders' Equity for further details.

NOTE B – ACQUISITIONS, DIVESTITURES AND STRATEGIC INVESTMENTS

Our accompanying unaudited consolidated financial statements include the operating results for acquired entities from the respective dates of acquisition. We completed 3 acquisitions1 acquisition in the first six months of 2022, and 1 acquisition and 1 divestiture in the first ninesix months of 2021 and did not complete any significant acquisitions or divestitures during the first nine months of 2020.2021. We have not presented supplemental pro forma financial information for completed acquisitions or divestitures given their results are not material to our accompanying unaudited consolidated financial statements. Further, transaction costs were immaterial to our accompanying unaudited consolidated financial statements and were expensed as incurred.

In addition, on September 21, 2021,On June 15, 2022, we announced our entry into a definitive agreement with Synergy Innovation Co, Ltd, to acquire Devoro Medical, Inc. (Devoro Medical)purchase its majority stake of M.I. Tech Co., Ltd., (M.I. Tech), a privately-held company which has developedpublicly traded Korean manufacturer and distributor of medical devices for endoscopic and urologic procedures. The agreement, whereby we will purchase approximately 64 percent of the WOLF Thrombectomy® Platform, designed to capture and extract blood clots in arterial, venous and pulmonary embolism procedures. We have been an investor in Devoro Medical since 2019 and hold an equity stakeoutstanding shares of approximately 16 percent. The transaction priceM.I. Tech, consists of an upfront cash paymenta purchase price of $320 million,KRW 291.2 billion or approximately $269$230 million, after adjustments for our current equity ownership, debt, and othersubject to closing adjustments; and up to $80 million upon achievement of certain clinical and regulatory milestones, or approximately $67 million after adjustments for current equity ownership.adjustments. The acquisition is expected to close induring the fourth quartersecond half of 2021,2022, subject to customary closing conditions. Following the closing of the acquisition, we planThe M.I. Tech stent portfolio complements our existing Endoscopy portfolio which will give physicians more treatment options to integrate the Devoro Medical business into our Peripheral Interventions division.meet specific patient needs.

2022 Acquisition

Further, on October 6, 2021,On February 14, 2022, we announcedcompleted our entry into a definitive agreement to acquireacquisition of Baylis Medical Company Inc. (Baylis Medical), a privately-held company which has developed the radiofrequcncyradiofrequency (RF) NRG and VersaCrossTransseptal Platforms as well as a family of guidewires, sheaths and dilators used to support left heart access, which will expandexpands our electrophysiology and structural heart product portfolios. The transaction consistsconsisted of an upfront cash payment of $1.75$1.471 billion, net of cash acquired, subject to closing adjustments. The acquisition is expected to close during the first quarter of 2022, subject to customary closing conditions. Following the closing of the acquisition, we plan to integrateWe are integrating the Baylis Medical business into our ElectrophysiologyCardiology division.

2021 Acquisitions
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Purchase Price Allocation

The preliminary purchase price was comprised of the amounts presented below, which represent the preliminary determination of the fair value of identifiable assets acquired and liabilities assumed. The final determination of the fair value of certain assets and liabilities will be completed within the measurement period in accordance with Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 805, Business Combinations (FASB ASC Topic 805).

(in millions)
Payment for acquisition, net of cash acquired$1,471 
$1,471

The preliminary purchase price allocation was comprised of the following components:
(in millions)
Goodwill$989 
Amortizable intangible assets657 
Other assets acquired113 
Liabilities assumed(280)
Net deferred tax liabilities(8)
$1,471

Goodwill was primarily established due to synergies expected to be gained from leveraging our existing operations, as well as revenue and cash flow projections associated with future technologies and is not deductible for tax purposes.

We allocated a portion of the preliminary purchase price to the specific intangible asset categories as follows:
Amount Assigned
(in millions)
Weighted Average Amortization Period
(in years)
Risk-Adjusted Discount
Rates used in Purchase Price Allocation
Amortizable intangible assets:
Technology-related$622 1111%
Other intangible assets36 1111%
$657 
2021 Acquisition

On March 1, 2021, we completed the acquisition of Preventice Solutions, Inc. (Preventice), a privately-held company which offers a full portfolio of mobile cardiac health solutions and services, ranging from ambulatory cardiac monitors, to cardiac
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event monitors and mobile cardiac telemetry. The transaction consisted of an upfront cash payment of $925 million and up to an additional $300 million in a potential commercial milestone payment. We havehad been an investor in Preventice since 2015 and held an equity stake of approximately 22 percent immediately prior to the acquisition date. We remeasured the fair value of our previously-held investment based on the allocation of the purchase price according to priority of equity interests, which resulted in a $195 million gain recognized within Other, net in the first quarter of 2021. The transaction price for the remaining stake consisted of an upfront cash payment of $706 million, net of cash acquired, and up to approximately $230an additional revenue-based milestone payment of $216 million in future milestone payments.made during the second quarter of 2022. The Preventice business is being managed by our Cardiac Rhythm ManagementCardiology division.

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On August 6, 2021, we completed our acquisitionTable of the remaining shares of Farapulse, Inc. (Farapulse), a privately-held company that has developed a non-thermal ablation system for the treatment of atrial fibrillation (AF) and other cardiac arrhythmias. The transaction consisted of an upfront cash payment of $450 million, up to $125 million upon achievement of certain clinical and regulatory milestones and additional revenue-based payments over the next three years. We have been an investor in Farapulse since 2014 and held an equity stake of approximately 27 percent immediately prior to the acquisition date. We remeasured the fair value of our previously-held investment based on the allocation of the purchase price according to priority of equity interests which resulted in a $222 million gain recognized within Other, net during the third quarter of 2021. The transaction price for the remaining stake consisted of an upfront cash payment of $268 million, net of cash acquired, and up to approximately $92 million in future milestone payments. The Farapulse business is being integrated into our Electrophysiology division.Contents

On September 1, 2021, we completed our acquisition of the global surgical business of Lumenis LTD. (Lumenis), a privately-held company that develops and commercializes energy-based medical solutions, including innovative laser systems, fibers and accessories used for urology and otolaryngology procedures. The transaction consisted of an upfront cash payment of $1.039 billion, net of cash acquired. The Lumenis business is being integrated into our Urology and Pelvic Health division.

Purchase Price Allocation

The preliminary purchase priceWe accounted for the acquisitions completed duringacquisition of Preventice as a business combination, and in accordance with FASB ASC Topic 805, we recorded the first nine months of 2021 was comprised of the amounts presented below, which represent the preliminary determination of the fair value of identifiable assets acquired and liabilities assumed.assumed at their respective fair values as of the acquisition date. The final determination of the fair value of certain assets and liabilities, in particular those associated with our acquisition of Lumenis, will be completed within the measurement period in accordance with Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 805, Business Combinations. Due to the timing of the Lumenis acquisition, efforts to obtain information and complete the valuation studies necessary to determine the fair value of the various purchase price components are still ongoing.

(in millions)PreventiceLumenisFarapulseTotal
Payment for acquisition, net of cash acquired$706 $1,039 $268 $2,014 
Fair value of contingent consideration221 — 162 384 
Fair value of prior interest269 — 222 491 
$1,197 $1,039 $653 $2,889 

The preliminary purchase price allocation for these acquisitions was comprised of the following components:
(in millions)PreventiceLumenisFarapulseTotal
Goodwill$926 $582 $386 $1,894 
Amortizable intangible assets237 459 267 964 
Indefinite-lived intangible assets— — 43 43 
Other assets acquired65 115 190 
Liabilities assumed(32)(86)(10)(127)
Net deferred tax liabilities— (32)(43)(74)
$1,197 $1,039 $653 $2,889 

(in millions)
Payment for acquisition, net of cash acquired$706 
Fair value of contingent consideration221 
Fair value of prior interest269 
$1,197

(in millions)
Goodwill$926 
Amortizable intangible assets237 
Other assets acquired65 
Liabilities assumed(32)
$1,197

We allocated a portion of the purchase price to the specific intangible asset categories as follows:

Amount Assigned
(in millions)
Weighted Average Amortization Period
(in years)
Risk-Adjusted Discount
Rates used in Purchase Price Allocation
Amortizable intangible assets:
Technology-related$215 910%
Other intangible assets22 810%
$237 

Goodwill was primarily established due to synergies expected to be gained from leveraging our existing operations, as well as revenue and cash flow projections associated with future technologies, and is not deductible for tax purposes.
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We allocated a portionIn the second quarter of 2022 we recorded certain measurement period adjustments related to our prior year acquisition of the preliminary purchase pricesurgical business of Lumenis, LTD. (Lumenis). We recorded an accrued income tax liability within Other non-current liabilities within our accompanying unaudited consolidated balance sheets of $177 million related to uncertain tax positions assumed in connection with the acquisition. We were indemnified by the sellers for the majority of such tax obligations and recognized a corresponding indemnification asset of $172 million at the acquisition date within Other non-current assets within our accompanying unaudited consolidated balance sheets. Subsequent to the specific intangibleacquisition date, interest and penalties accrued on the tax liability are being recorded within Income tax expense (benefit) and corresponding adjustments to the indemnification asset categories as follows:
Amount Assigned
(in millions)
Weighted Average Amortization Period
(in years)
Risk-Adjusted Discount
Rates used in Purchase Price Allocation
Preventice:
Amortizable intangible assets:
Technology-related$215 910%
Other intangible assets22 810%
$237 
Lumenis:
Amortizable intangible assets:
Technology-related$417 1411%
Other intangible assets42 1311%
$459 
Farapulse:
Amortizable intangible assets:
Technology-related$267 1216%
Indefinite-lived intangible assets:
In-process research and development (IPR&D)43 N/A17%
$310 
are being recorded in Other, net within our accompanying unaudited consolidated statements of operations. The outcome of these matters is subject to uncertainty and ultimately, the amount of tax due and the related indemnification reimbursement we receive will be dependent on the outcome of tax return examinations by relevant authorities. Refer to Note F – Supplemental Balance Sheet Information for further details regarding our indemnification asset.

2021 Divestiture

On March 1, 2021, we completed the divestiture of the Specialty Pharmaceuticals business to Stark International Lux S.A.R.L., and SERB SAS, affiliates of SERB, a European specialty pharmaceutical group, for a purchase price of approximately $800 million, which was subject to certain adjustments including cash on hand at the closing of the transaction. The agreement included the transfer of 5 facilities and approximately 280 employees globally.

We classifiedIn the assetssecond quarter and liabilitiesfirst six months of 2021, we recognized a Gain on disposal of businesses and assets associated with the Specialty Pharmaceuticals business (disposal group) as held for saletransaction of $2 million and $9 million, respectively, within our accompanying unaudited consolidated balance sheet asstatements of December 31, 2020 at their respective carrying values, which approximated fair value, less costs to sell. Assets within the disposal group are presented within
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Assets held for sale and liabilities are presented within Other current liabilities within our consolidated balance sheet asTable of December 31, 2020.Contents

operations. Refer to Note C – Assets and Liabilities Held for Sale to our audited financial statements contained in Item 8 of our most recent Annual Report on Form 10-K for additional information. In the first nine months of 2021, we recognized a Gain on disposal of businesses and assets associated with the transaction of $9 million within our accompanying unaudited consolidated statements of operations.

Contingent Consideration

Changes in the fair value of our contingent consideration liability during the first ninesix months of 20212022 were as follows:

(in millions)
Balance as of December 31, 20202021$196486 
Amount recorded related to current year acquisitions384 
Contingent consideration net expense (benefit)(117)48 
Contingent consideration payments(14)(314)
Balance as of SeptemberJune 30, 20212022$448219 

As of SeptemberJune 30, 2021,2022, the maximum amount of future contingent consideration (undiscounted) that we could be required to pay associated with our completed acquisitions was $919 million, which includes amounts related to our recent acquisitions of
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Preventice and Farapulse.$544 million. Refer to Note B – Acquisitions and Strategic Investmentsto our audited financial statements contained in Item 8 of our most recent Annual Report on Form 10-K for additional information.

The recurring Level 3 fair value measurements of our contingent consideration liability that we expect to be required to settle include the following significant unobservable inputs:
Contingent Consideration LiabilityContingent Consideration LiabilityFair Value as of September 30, 2021Valuation TechniqueUnobservable InputRange
Weighted Average(1)
Contingent Consideration LiabilityFair Value as of June 30, 2022Valuation TechniqueUnobservable InputRange
Weighted Average(1)
R&D, Regulatory and Commercialization-based MilestonesR&D, Regulatory and Commercialization-based Milestonestd09 millionDiscounted Cash FlowDiscount Rate1%-2%1%R&D, Regulatory and Commercialization-based Milestonestd07 millionDiscounted Cash FlowDiscount Rate1%-2%1%
Probability of Payment20%-95%79%Probability of Payment80%-100%90%
Projected Year of Payment2023-20272023Projected Year of Payment2022-20252023
Revenue-based PaymentsRevenue-based Payments$340 millionDiscounted Cash FlowDiscount Rate4%-14%6%Revenue-based Paymentstd12 millionDiscounted Cash FlowDiscount Rate6%-14%7%
Probability of Payment100%100%Probability of Payment100%100%
Projected Year of Payment2021-20242022Projected Year of Payment2023-20242023
(1)    Unobservable inputs were weighted by the relative fair value of the contingent consideration liability. For projected year of payment, the amount represents the median of the inputs and is not a weighted average.

Projected contingent payment amounts related to research and development (R&D), regulatory and commercialization-based milestones and revenue-based milestonespayments are discounted back to the current period, primarily using a discounted cash flow model. Significant increases or decreases in projected revenues, probabilities of payment, discount rates or the time until payment is made would have resulted in a significantly lower or higher fair value measurement as of SeptemberJune 30, 2021.2022.

Strategic Investments

The aggregate carrying amount of our strategic investments was comprised of the following:


As of

As of
(in millions)(in millions)September 30, 2021December 31, 2020(in millions)June 30, 2022December 31, 2021
Equity method investmentsEquity method investments$266 $319 Equity method investments$212 $259 
Measurement alternative investments(1)
Measurement alternative investments(1)
164 183 
Measurement alternative investments(1)
159 142 
Publicly-held equity securities(2)
414 
Publicly-held securities(2)
Publicly-held securities(2)
10 
Notes receivableNotes receivable— Notes receivable— 
$434 $918 $384 $412 
(1)    Measurement alternative investments are privately-held equity securities without readily determinable fair values that are measured at cost less impairment, if any, adjusted to fair value for any observable price changes in orderly transactions for the identical or a similar investment of the same issuer, recognized in Other, net within our accompanying unaudited consolidated statements of operations.
(2)    Publicly-held equity securities are measured at fair value with changes in fair value recognized in Other, net within our accompanying unaudited consolidated statements of operations.

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These investments are classified as Other long-term assets within our accompanying unaudited consolidated balance sheets, in accordance with U.S. GAAP and our accounting policies.

In the third quarter and first nine months of 2021, we recorded losses of $24 million and $178 million, respectively, on our investment in Pulmonx Corporation presented in Other, net associated with the remeasurement of our investment during the period to fair value based on observable market prices, as well as the disposition of our remaining ownership. On March 1, 2021, we completed our acquisition of Preventice, in which we previously held an equity interest of approximately 22 percent and on August 6, 2021, we completed the acquisition of the remaining shares of Farapulse, in which we previously held an equity stake of approximately 27 percent. As of SeptemberJune 30, 2021,2022, the cost of our aggregated equity method investments exceeded our share of the underlying equity in net assets by $289$233 million, which represents amortizable intangible assets, in-process research and development (IPR&D), goodwill and deferred tax liabilities.

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NOTE C – GOODWILL AND OTHER INTANGIBLE ASSETS

The gross carrying amount of goodwill and other intangible assets and the related accumulated amortization for intangible assets subject to amortization and accumulated write-offs of goodwill impairment charges are as follows:
As of September 30, 2021As of December 31, 2020
(in millions)Gross Carrying Amount
Accumulated Amortization/ Write-offs(1)
Gross Carrying AmountAccumulated Amortization/ Write-offs
Technology-related$11,787 $(6,590)$11,059 $(6,179)
Patents497 (399)511 (407)
Other intangible assets1,859 (1,301)1,775 (1,220)
Amortizable intangible assets$14,143 $(8,290)$13,345 $(7,806)
    
Goodwill$21,720 $(9,900)$19,924 $(9,973)
IPR&D$254 $257 
Technology-related120 120 
Indefinite-lived intangible assets$374 $377 
(1)    In the fourth quarter of 2020, we recorded goodwill impairment charges of $73 million related to the Specialty Pharmaceuticals business and classified the remaining assets and liabilities as held for sale as of December 31, 2020. On March 1, 2021, we completed the divestiture of the Specialty Pharmaceuticals business. The goodwill impairment charges of $73 million related to the Specialty Pharmaceuticals business are no longer presented within accumulated write-offs above as of September 30, 2021.
As of June 30, 2022As of December 31, 2021
(in millions)Gross Carrying AmountAccumulated Amortization/ Write-offsGross Carrying AmountAccumulated Amortization/ Write-offs
Technology-related$12,515 $(7,078)$11,957 $(6,754)
Patents487 (392)494 (398)
Other intangible assets1,953 (1,368)1,900 (1,325)
Amortizable intangible assets$14,955 $(8,838)$14,351 $(8,476)
    
Goodwill$22,783 $(9,900)$21,888 $(9,900)
IPR&D$112 $126 
Technology-related120 120 
Indefinite-lived intangible assets$232 $246 

The increase in our balance of goodwill and amortizable intangible assets is primarily related to our acquisitionsacquisition of Baylis Medical completed in the first nine monthsquarter of 2021.

Our technology-related intangible assets consist of technical processes, intellectual property and institutional understanding with respect to products and processes that we intend to leverage in future products or processes and will carry forward from one product generation to the next. We used the multi-period excess earnings method, a form of the income approach, to derive the fair value of the technology-related intangible assets and are amortizing them on a straight-line basis over their assigned estimated useful lives. Our in-process research and development (IPR&D) represents intangible assets that are used in research and development activities but have not yet reached technological feasibility, regardless of whether they have alternative future use. The primary basis for determining the technological feasibility or completion of these projects is obtaining regulatory approval to market the underlying products in an applicable geographic region.2022.

The following represents our goodwill balance by global reportable segment:
(in millions)MedSurgRhythm and NeuroCardiovascularTotal
As of December 31, 2020$2,059 $2,194 $5,697 $9,951 
Impact of foreign currency fluctuations and other changes in carrying amount(4)(1)(15)(20)
Goodwill acquired578 1,312 — 1,890 
As of September 30, 2021$2,633 $3,506 $5,682 $11,820 
(in millions)MedSurgCardiovascularTotal
As of December 31, 2021$4,246 $7,741 $11,988 
Impact of foreign currency fluctuations and other changes in carrying value(5)(88)(93)
Goodwill acquired— 989 989 
As of June 30, 2022$4,241 $8,642 $12,883 

PriorIn the first quarter of 2022, we reorganized our operational structure in order to strengthen our category leadership in the markets we serve and, in particular, benefit our Cardiology customers and patients. Following the reorganization, we have aggregated our core businesses into 2 reportable segments: MedSurg and Cardiovascular, each of which generates revenues from the sale of medical devices. We have revised prior periods to conform to the divestiture on March 1, 2021, we presented the Specialty Pharmaceuticals business as a standalone operating segment alongside our reportable segments.current year presentation.

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Goodwill and Intangible Asset Impairments

We did not record any goodwill impairment charges in the third quarter or first ninesix months of 20212022 or 2020.2021. We test our goodwill balances in the second quarter of each year as of April 1 for impairment, or more frequently if impairment indicators are present or changes in circumstances suggest an impairment may exist. In the second quarter of 2021, we performed our annual goodwill impairment test for all of our reporting units and concluded that the fair value of each reporting unit exceeded its carrying value. There were no impairment indicators in the third quarter of 2021 that necessitated an interim impairment test.

We assess goodwill for impairment at the reporting unit level, which is defined as an operating segment or one level below an operating segment, referred to as a component. WeFollowing the reorganization of our operational structure in the first quarter of 2022, we identified the following reporting units infor purposes of our 2021 annual goodwill impairment test: Interventional Cardiology, Peripheral Interventions, Cardiac Rhythm Management, Electrophysiology,Peripheral Interventions, Endoscopy, Urology and Pelvic Health and Neuromodulation. We aggregated the Cardiac Rhythm Management and Electrophysiology reporting units, components of the Rhythm Management operating segment, basedBased on the criteria prescribed in FASB ASC Topic 350, Intangibles - Goodwill and Other.Other (FASB ASC Topic 350), we aggregated the Interventional Cardiology Therapies and Watchman components of our Cardiology operating segment into a
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single Interventional Cardiology reporting unit, and aggregated the Cardiac Rhythm Management and Electrophysiology components into a single Rhythm Management reporting unit.

In the second quarter of 2022, we performed our annual goodwill impairment test utilizing both the qualitative and quantitative approach described in FASB ASC Topic 350. The qualitative approach was used for testing reporting units where fair value has historically exceeded carrying value by greater than 100 percent, and all other reporting units were tested using the quantitative approach. For those tested using the qualitative approach, after assessing the totality of events, it was determined that it was not more likely than not that the fair value of the reporting units was less than their carrying value, and it was not deemed necessary to proceed to the quantitative test. For all reporting units tested using the quantitative approach, we determined that the fair value of each reporting unit exceeded their carrying value and concluded that goodwill was not impaired or at risk of impairment.

We recorded Intangible asset impairment charges of $128$7 million in the thirdsecond quarter and first six months of 2021, $2192022, and $45 million in the thirdsecond quarter of 2020, $173 million in theand first ninesix months of 2021 and $452 million in the first nine months of 2020.2021. We review intangible assets subject to amortization quarterly to determine if any adverse conditions exist or a change in circumstances has occurred that would indicate impairment or a change in the remaining useful life. We test our indefinite-lived intangible assets at least annually during the third quarter for impairment and reassess their classification as indefinite-lived assets. In addition, we review our indefinite-lived intangible assets for classification and impairment more frequently if impairment indicators exist. InDuring the thirdsecond quarter of 2021, we performed our annual IPR&D impairment test and evaluateddetermined it was more likely than not that one of our indefinite-lived core technologyintangible assets using the optionalwas impaired based on our qualitative assessment approachof impairment indicators. We tested the intangible asset for recoverability and concluded thatrecorded an impairment charge associated with incremental time and cost to complete the assets were not impaired. We also verified that the classification of IPR&D projectsassociated in-process research and our indefinite-lived core technology assets recognized within our unaudited consolidated balance sheets continues to be appropriate.development (IPR&D) project.

The impairment charges recorded in the third quarter of 2021 were primarily associated with amortizable technology-related intangible assets that were initially established following our acquisition of VENITI, Inc., and in the first nine months of 2021 also included the partial impairment of one of our acquired IPR&D assets. In the third quarter of 2020, impairment charges were primarily associated with IPR&D acquired with Apama Medical, Inc. and in the first nine months of 2020 also included charges primarily associated with amortizable technology-related intangible assets that were initially established following our acquisition of nVision Medical Corporation. Each of these charges were recorded as a result of management’s decision to change commercial launch plans or discontinue certain commercial or R&D programs based on cost to complete or remediate, time to market, overall economic viability or, specific to nVision, our understanding of the clinical evidence necessary to commercialize the technology. Refer to Note A – Significant Accounting PoliciesBasis of Presentation to our audited financial statements contained in Item 8 of our most recent Annual Report on Form 10-K for further discussion of our annual goodwill and intangible asset impairment testing.

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NOTE D – HEDGING ACTIVITIES AND FAIR VALUE MEASUREMENTS

Derivative Instruments and Hedging Activities

We address market risk from changes in foreign currency exchange rates and interest rates through risk management programs which include the use of derivative and nonderivative financial instruments. We operate these programs pursuant to documented corporate risk management policies and do not enter into derivative transactions for speculative purposes. Our derivative instruments do not subject our earnings to material risk, as the gains or losses on these derivatives generally offset losses or gains recognized on the hedged item.

We manage concentration of counterparty credit risk by limiting acceptable counterparties to major financial institutions with investment grade credit ratings, limiting the amount of credit exposure to individual counterparties and by actively monitoring counterparty credit ratings and the amount of individual credit exposure.ratings. We also employ master netting arrangements that limit the risk of counterparty non-payment on a particular settlement date to the net gain that would have otherwise been received from the counterparty. Although not completely eliminated, we do not consider the risk of counterparty default to be significant as a result of these protections. Further, none of our derivative instruments are subject to collateral or other security arrangements, nor do they contain provisions that are dependent on our credit ratings from any credit rating agency.

Currency Hedging Instruments

Risk Management Strategy

Our risk from changes in currency exchange rates consists primarily of monetary assets and liabilities, forecasted intercompany and third-party transactions, and net investments in certain subsidiaries. We manage currency exchange rate risk at a consolidated level to reduce the cost of hedging by taking advantage of offsetting transactions. We employ derivative and nonderivative instruments, primarily forward currency contracts, to reduce the risk to our earnings and cash flows associated with changes in currency exchange rates.

The success of our currency risk management program depends, in part, on forecast transactions denominated primarily in Euro,euro, British pound sterling, Japanese yen, Chinese renminbi and Australian dollar. We may experience unanticipated currency exchange gains or losses to the extent the actual activity is different than forecast. In addition, changes in currency exchange rates related to any unhedged transactions may impact our earnings and cash flows.

Hedge Designations and Relationships

Certain of our currency derivative instruments are designated as cash flow hedges under FASB ASC Topic 815, Derivatives and Hedging (FASB ASC Topic 815), and are intended to protect the U.S. dollar value of forecasted transactions. The gain or loss on a derivative instrument designated as a cash flow hedge is recorded in the Net change in derivative financial instruments component of Other comprehensive income (loss), net of tax (OCI) within our accompanying unaudited consolidated statements of comprehensive income (loss) until the underlying third-party transaction occurs. When the underlying third-party transaction occurs, we recognize the gain or loss in earnings within Cost of products sold in our accompanying unaudited consolidated statements of operations. In the event the hedging relationship is no longer effective, or if the occurrence of the hedged forecast transaction becomes no longer probable, we reclassify the gains or losses within Accumulated other comprehensive income (loss), net of tax (AOCI) to earnings at that time.

We also designate certain forward currency contracts as net investment hedges to hedge a portion of our net investments in certain of our entities with functional currencies denominated in the Swiss franc, Japanese yen, British pound sterling, South Korean won and Taiwan dollar. For these derivative instruments, we elected to use the spot method to assess hedge effectiveness. We also elected to exclude the spot-forward difference, referred to as the excluded component, from the assessment of hedge effectiveness and are amortizing this amount separately, as calculated at the date of designation, on a straight-line basis over the term of the currency forward contracts. As such, we defer recognition of foreign currency gains and losses within the Foreign currency translation adjustment (CTA) component of OCI, and we reclassify amortization of the excluded component from AOCI to current period earnings within Interest expense in our accompanying unaudited consolidated statements of operations.

We designate certain euro-denominated debt as net investment hedges to hedge a portion of our net investments in certain of our entities with functional currencies denominated in the Euro. As of SeptemberJune 30, 20212022 and December 31, 2020,2021, we designated as a net investment hedge a portion of our €900 million in aggregate principal amount of 0.625% euro-denominated senior notes issued in November 2019 and due in 2027.2027 (2027 Notes). For these nonderivative instruments, we defer recognition of the foreign currency
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foreign currency remeasurement gains and losses within the CTA component of OCI. We reclassify these gains and losses to current period earnings within Other, net in our accompanying unaudited consolidated statements of operations only when the hedged item affects earnings, which would occur upon disposal or substantial liquidation of the underlying foreign subsidiary.

We also use forward currency contracts that are not part of designated hedging relationships under FASB ASC Topic 815 as a part of our strategy to manage our exposure to currency exchange rate risk related to monetary assets and liabilities and related forecast transactions. These non-designated currency forward contracts have an original time to maturity consistent with the hedged currency transaction exposures, generally less than one year, and are marked-to-market with changes in fair value recorded to earnings within Other, net inwithin our accompanying unaudited consolidated statements of operations.

Interest Rate Hedging Instruments
Risk Management Strategy

Our interest rate risk relates primarily to U.S. dollar borrowings partially offset by U.S. dollar cash investments. We use interest rate derivative instruments to mitigate the risk to our earnings and cash flows associated with exposure to changes in interest rates. Under these agreements, we and the counterparty, at specified intervals, exchange the difference between fixed and floating interest amounts calculated by reference to an agreed-upon notional principal amount. We designate these derivative instruments either as fair value or cash flow hedges in accordance with FASB ASC Topic 815.

Hedge Designations and Relationships

We had no interest rate derivative instruments designated as cash flow hedges outstanding as of SeptemberJune 30, 20212022 or December 31, 2020.2021. Prior to 2020, we terminated interest rate derivative instruments that were designated as cash flow hedges and are continuing to recognize the amortization of the gains or losses originally recorded within AOCI to earnings as a component of Interest expense over the same period that the hedged item affects earnings, provided the hedge relationship remains effective. If we determine the hedge relationship is no longer effective, or if the occurrence of the hedged forecast transaction becomes no longer probable, we reclassify the amount of gains or losses from AOCI to earnings at that time.

In the event that we designate outstanding interest rate derivative instruments as cash flow hedges, we record the changes in the fair value of the derivatives within OCI until the underlying hedged transaction occurs. The balance of the deferred amounts on our terminated cash flow hedges within AOCI was a $25$9 million loss as of SeptemberJune 30, 20212022 and a $29$24 million loss as of December 31, 2020. We recognized immaterial gains and losses in 2021.Interest expense relating to the amortization of our terminated cash flow hedges in the current and prior periods.

We had no interest rate derivative instruments designated as fair value hedges outstanding as of September 30, 2021 or December 31, 2020. Prior to 2018, we terminated interest rate derivative instruments that were designated as fair value hedges and are continuing to recognize the amortization of the gains or losses originally recorded within Long-term debt in our accompanying unaudited consolidated balance sheets into earnings as a component of Interest expense over the same period that the discount or premium associated with the hedged items affects earnings. In the event that we designate outstanding interest rate derivative instruments as fair value hedges, we record the changes in the fair values of interest rate derivatives designated as fair value hedges and of the underlying hedged debt instruments in Interest expense, which generally offset. The balance of the deferred gains on our terminated fair value hedges within Long-term debt was immaterial as of September 30, 2021 and December 31, 2020. We recognized immaterial gains in Interest expense relating to the amortization of the terminated fair value hedges in the current and prior periods.

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The following table presents the contractual amounts of our hedging instruments outstanding:
(in millions)(in millions)FASB ASC Topic 815 DesignationAs of(in millions)FASB ASC Topic 815 DesignationAs of
September 30, 2021December 31, 2020June 30, 2022December 31, 2021
Forward currency contractsForward currency contractsCash flow hedge$4,344 $4,531 Forward currency contractsCash flow hedge$3,527 $3,996 
Forward currency contractsForward currency contractsNet investment hedge493 1,004 Forward currency contractsNet investment hedge365 493 
Foreign currency-denominated debt(1)
Foreign currency-denominated debt(1)
Net investment hedge997 868 
Foreign currency-denominated debt(1)
Net investment hedge997 997 
Forward currency contractsForward currency contractsNon-designated4,838 4,946 Forward currency contractsNon-designated3,029 3,892 
Total Notional OutstandingTotal Notional Outstanding$10,672 $11,349 Total Notional Outstanding$7,917 $9,378 
(1)    Foreign currency-denominated debt is the portion of the €900 million debt principal associated with our 2027 Notes designated as a net investment hedge.

The remaining time to maturity as of SeptemberJune 30, 20212022 is within 60 months for all forward currency contracts designated as cash flow hedges and generally less than one year for all non-designated forward currency contracts. The forward currency contracts designated as net investment hedges generally mature within the next year.between one and three years. The euro-denominated debt principal designated as a net investment hedge has a contractual maturity of December 1, 2027.

The following presents the effect of our derivative and nonderivative instruments designated as cash flow and net investment hedges under FASB ASC Topic 815 in our accompanying unaudited consolidated statements of operations. Refer to Note M – Changes in Other Comprehensive Income for the total amounts relating to derivative and nonderivative instruments presented within our accompanying unaudited consolidated statements of comprehensive income (loss).

Effect of Hedging Relationships on Accumulated Other Comprehensive Income
Amount Recognized in OCI on Hedges
Unaudited Consolidated Statements of Operations(1)
Amount Reclassified from AOCI into Earnings
(in millions)Pre-Tax Gain (Loss)Tax Benefit (Expense)Gain (Loss) Net of TaxLocation of Amount Reclassified and Total Amount of Line ItemPre-Tax (Gain) LossTax (Benefit) Expense(Gain) Loss Net of Tax
Three Months Ended September 30, 2021
Forward currency contracts
Cash flow hedges$79 $(18)$61 Cost of products sold$900 $(16)$$(12)
Net investment hedges(2)
(2)Interest expense86 (2)— (2)
Foreign currency-denominated debt
Net investment hedges(3)
25 (6)20 Other, net(181)— — — 
Interest rate derivative contracts
Cash flow hedges— — — Interest expense86 — 
Effect of Hedging Relationships on Accumulated Other Comprehensive Income
Amount Recognized in OCI on Hedges
Unaudited Consolidated Statements of Operations(1)
Amount Reclassified from AOCI into Earnings
(in millions)Pre-Tax Gain (Loss)Tax Benefit (Expense)Gain (Loss) Net of TaxLocation of Amount Reclassified and Total Amount of Line ItemPre-Tax (Gain) LossTax (Benefit) Expense(Gain) Loss Net of Tax
Three Months Ended September 30, 2020
Forward currency contracts
Cash flow hedges$(64)$14 $(50)Cost of products sold$869 $(20)$$(15)
Net investment hedges(2)
(21)(16)Interest expense86 (6)(5)
Foreign currency-denominated debt
Net investment hedges(3)
(46)10 (36)Other, net(64)— — — 
Interest rate derivative contracts
Cash flow hedges— — — Interest Expense86 — 
Effect of Hedging Relationships on Accumulated Other Comprehensive Income
Amount Recognized in OCI on Hedges
Unaudited Consolidated Statements of Operations(1)
Amount Reclassified from AOCI into Earnings
(in millions)Pre-Tax Gain (Loss)Tax Benefit (Expense)Gain (Loss) Net of TaxLocation of Amount Reclassified and Total Amount of Line ItemPre-Tax (Gain) LossTax (Benefit) Expense(Gain) Loss Net of Tax
Nine Months Ended September 30, 2021
Forward currency contracts
Cash flow hedges$234 $(53)$182 Cost of products sold$2,739 $(31)$$(24)
Net investment hedges (2)50 (11)39 Interest expense254 (11)(9)
Foreign currency-denominated debt
Net investment hedges (3)60 (14)47 Other, net(192)— — — 
Interest rate derivative contracts
Cash flow hedges— — — Interest expense254 (1)
Effect of Hedging Relationships on Accumulated Other Comprehensive Income
Amount Recognized in OCI on Hedges
Unaudited Consolidated Statements of Operations(1)
Amount Reclassified from AOCI into Earnings
(in millions)Pre-Tax Gain (Loss)Tax Benefit (Expense)Gain (Loss) Net of TaxLocation of Amount Reclassified and Total Amount of Line ItemPre-Tax (Gain) LossTax (Benefit) Expense(Gain) Loss Net of Tax
Nine Months Ended September 30, 2020
Forward currency contracts
Cash flow hedges$47 $(11)$36 Cost of products sold$2,465 $(70)$16 $(55)
Net investment hedges (2)(4)(21)(25)Interest expense265 (18)(14)
Foreign currency-denominated debt
Net investment hedges (3)(44)13 (31)Other, net(9)— — — 
Interest rate derivative contracts
Cash flow hedges— — — Interest expense265 (1)
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Effect of Hedging Relationships on Accumulated Other Comprehensive Income
Amount Recognized in OCI on Hedges
Unaudited Consolidated Statements of Operations(1)
Amount Reclassified from AOCI into Earnings
(in millions)Pre-Tax Gain (Loss)Tax Benefit (Expense)Gain (Loss) Net of TaxLocation of Amount Reclassified and Total Amount of Line ItemPre-Tax (Gain) LossTax (Benefit) Expense(Gain) Loss Net of Tax
Three Months Ended June 30, 2022
Forward currency contracts
Cash flow hedges$213 $(48)$165 Cost of products sold$1,011 $(41)$$(32)
Net investment hedges(2)
34 39 Interest expense64 (3)(2)
Foreign currency-denominated debt
Net investment hedges(3)
62 (14)48 Other, net14 — — — 
Interest rate derivative contracts
Cash flow hedges— — — Interest expense64 — 

Effect of Hedging Relationships on Accumulated Other Comprehensive Income
Amount Recognized in OCI on Hedges
Unaudited Consolidated Statements of Operations(1)
Amount Reclassified from AOCI into Earnings
(in millions)Pre-Tax Gain (Loss)Tax Benefit (Expense)Gain (Loss) Net of TaxLocation of Amount Reclassified and Total Amount of Line ItemPre-Tax (Gain) LossTax (Benefit) Expense(Gain) Loss Net of Tax
Three Months Ended June 30, 2021
Forward currency contracts
Cash flow hedges$(15)$$(12)Cost of products sold$945 $(10)$$(7)
Net investment hedges(2)
(8)(7)Interest expense86 (3)(3)
Foreign currency-denominated debt
Net investment hedges(3)
(12)(10)Other, net26 — — — 
Interest rate derivative contracts
Cash flow hedges— — — Interest Expense86 — 

Effect of Hedging Relationships on Accumulated Other Comprehensive Income
Amount Recognized in OCI on Hedges
Unaudited Consolidated Statements of Operations(1)
Amount Reclassified from AOCI into Earnings
(in millions)Pre-Tax Gain (Loss)Tax Benefit (Expense)Gain (Loss) Net of TaxLocation of Amount Reclassified and Total Amount of Line ItemPre-Tax (Gain) LossTax (Benefit) Expense(Gain) Loss Net of Tax
Six Months Ended June 30, 2022
Forward currency contracts
Cash flow hedges$259 $(58)$200 Cost of products sold$1,966 $(71)$16 $(55)
Net investment hedges (2)
49 50 Interest expense343 (5)(4)
Foreign currency-denominated debt
Net investment hedges (3)
86 (19)66 Other, net46 — — — 
Interest rate derivative contracts
Cash flow hedges— — — Interest expense343 15 (3)11 

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Effect of Hedging Relationships on Accumulated Other Comprehensive Income
Amount Recognized in OCI on Hedges
Unaudited Consolidated Statements of Operations(1)
Amount Reclassified from AOCI into Earnings
(in millions)Pre-Tax Gain (Loss)Tax Benefit (Expense)Gain (Loss) Net of TaxLocation of Amount Reclassified and Total Amount of Line ItemPre-Tax (Gain) LossTax (Benefit) Expense(Gain) Loss Net of Tax
Six Months Ended June 30, 2021
Forward currency contracts
Cash flow hedges$156 $(35)$121 Cost of products sold$1,839 $(16)$$(12)
Net investment hedges (2)
43 (10)33 Interest expense168 (9)(7)
Foreign currency-denominated debt
Net investment hedges (3)
35 (8)27 Other, net(11)— — — 
Interest rate derivative contracts
Cash flow hedges— — — Interest expense168 (1)
(1)    In all periods presented in the table above, the pre-tax (gain) loss amounts reclassified from AOCI to earnings represent the effect of the hedging relationships on earnings. All other amounts included in earnings related to hedging relationships were immaterial.
(2)    For our outstanding forward currency contracts designated as net investment hedges, the net gain or loss reclassified from AOCI to earnings as a reduction of Interest expense represents the straight-line amortization of the excluded component as calculated at the date of designation. This initial value of the excluded component has been excluded from the assessment of effectiveness in accordance with FASB ASC Topic 815. In the current and prior period, we did not recognize any gains or losses on the components included in the assessment of hedge effectiveness in earnings.
(3)    For our outstanding euro-denominated debt principal designated as a net investment hedge, the change in fair value attributable to changes in the spot rate is recorded in the CTA component of OCI. No amounts were reclassified from AOCI to current period earnings.

As of SeptemberJune 30, 2021,2022, pre-tax net gains or losses for our derivative instruments designated, or previously designated, as cash flow and net investment hedges under FASB ASC Topic 815 that may be reclassified from AOCI to earnings within the next twelve months are presented below (in millions):
Designated Hedging InstrumentFASB ASC Topic 815 DesignationLocation on Unaudited Consolidated Statements of OperationsAmount of Pre-Tax Gain (Loss) that may be Reclassified to Earnings
Forward currency contractsCash flow hedgeCost of products sold$108251 
Forward currency contractsNet investment hedgeInterest expense510 
Interest rate derivative contractsCash flow hedgeInterest expense(5)(3)

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Net gains and losses on currency hedge contracts not designated as hedging instruments offset by net gains and losses from currency transaction exposures are presented below:
Location on Unaudited Consolidated Statements of OperationsThree Months Ended September 30,Nine Months Ended September 30,Location on Unaudited Consolidated Statements of OperationsThree Months Ended June 30,Six Months Ended June 30,
(in millions)(in millions)2021202020212020(in millions)2022202120222021
Net gain (loss) on currency hedge contractsNet gain (loss) on currency hedge contractsOther, net$(15)$29 $(17)$20 Net gain (loss) on currency hedge contractsOther, net$(34)$(1)$(63)$(2)
Net gain (loss) on currency transaction exposuresNet gain (loss) on currency transaction exposuresOther, net(30)(33)Net gain (loss) on currency transaction exposuresOther, net35 (5)56 (6)
Net currency exchange gain (loss)Net currency exchange gain (loss)$(8)$(1)$(17)$(13)Net currency exchange gain (loss)$1 $(7)$(7)$(9)

Fair Value Measurements

FASB ASC Topic 815 requires all derivative and nonderivative instruments to be recognized at their fair values as either assets or liabilities on the balance sheet. We determine the fair value of our derivative and nonderivative instruments using the framework prescribed by FASB ASC Topic 820, Fair Value Measurements and Disclosures (FASB ASC Topic 820) and considering the estimated amount we would receive or pay to transfer these instruments at the reporting date with respect to current currency exchange rates, interest rates, the creditworthiness of the counterparty for unrealized gain positions and our own creditworthiness for unrealized loss positions. In certain instances, we may utilize financial models to measure fair value of our derivative and nonderivative instruments. In doing so, we use inputs 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, other
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observable inputs for the asset or liability and inputs derived principally from, or corroborated by, observable market data by correlation or other means. The following are the balances of our derivative and nonderivative assets and liabilities:

Location on Unaudited Consolidated Balance Sheets(1)
As of
Location on Unaudited Consolidated Balance Sheets(1)
As of
(in millions)(in millions)September 30, 2021December 31, 2020(in millions)June 30, 2022December 31, 2021
Derivative and Nonderivative Assets:Derivative and Nonderivative Assets:   Derivative and Nonderivative Assets:   
Designated Hedging InstrumentsDesignated Hedging Instruments  Designated Hedging Instruments  
Forward currency contractsForward currency contractsOther current assets$152 $53 Forward currency contractsOther current assets$246 $183 
Forward currency contractsForward currency contractsOther long-term assets176 109 Forward currency contractsOther long-term assets252 169 
 328 162   498 352 
Non-Designated Hedging InstrumentsNon-Designated Hedging Instruments   Non-Designated Hedging Instruments   
Forward currency contractsForward currency contractsOther current assets41 79 Forward currency contractsOther current assets40 42 
Total Derivative and Nonderivative AssetsTotal Derivative and Nonderivative Assets $369 $242 Total Derivative and Nonderivative Assets $538 $394 
Derivative and Nonderivative Liabilities:Derivative and Nonderivative Liabilities:   Derivative and Nonderivative Liabilities:   
Designated Hedging InstrumentsDesignated Hedging Instruments  Designated Hedging Instruments  
Forward currency contractsForward currency contractsOther current liabilities$24 $44 Forward currency contractsOther current liabilities$10 $32 
Forward currency contractsForward currency contractsOther long-term liabilities54 Forward currency contractsOther long-term liabilities
Foreign currency-denominated debt(2)
Foreign currency-denominated debt(2)
Other long-term liabilities1,033 1,094 
Foreign currency-denominated debt(2)
Long-term debt926 1,011 
 1,063 1,191   938 1,049 
Non-Designated Hedging InstrumentsNon-Designated Hedging Instruments   Non-Designated Hedging Instruments   
Forward currency contractsForward currency contractsOther current liabilities57 71 Forward currency contractsOther current liabilities28 22 
Total Derivative and Nonderivative LiabilitiesTotal Derivative and Nonderivative Liabilities $1,120 $1,262 Total Derivative and Nonderivative Liabilities $966 $1,071 
(1)    We classify derivative and nonderivative assets and liabilities as current when the settlement date of the contract is one year or less.
(2)    Foreign currency-denominated debt is the portion of the €900 million debt principal associated with our 2027 Notes designated as a net investment hedge. A portion of this notional is subject to de-designation and re-designation based on changes in the underlying hedged item.

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Recurring Fair Value Measurements
On a recurring basis, we measure certain financial assets and financial liabilities at fair value based upon quoted market prices. Where quoted market prices or other observable inputs are not available, we apply valuation techniques to estimate fair value. FASB ASC Topic 820 establishes a three-level valuation hierarchy for disclosure of fair value measurements. The category of a financial asset or a financial liability within the valuation hierarchy is based upon the lowest level of input that is significant to the measurement of fair value. The three levels of the hierarchy are defined as follows:
Level 1 – Inputs to the valuation methodology are quoted market prices for identical assets or liabilities.
Level 2 – Inputs to the valuation methodology are other observable inputs, including quoted market prices for similar assets or liabilities and market-corroborated inputs.
Level 3 – Inputs to the valuation methodology are unobservable inputs based on management’s best estimate of inputs market participants would use in pricing the asset or liability at the measurement date, including assumptions about risk.
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Assets and liabilities measured at fair value on a recurring basis consist of the following:
As ofAs of
September 30, 2021December 31, 2020 June 30, 2022December 31, 2021
(in millions)(in millions)Level 1Level 2Level 3TotalLevel 1Level 2Level 3Total(in millions)Level 1Level 2Level 3TotalLevel 1Level 2Level 3Total
AssetsAssets        Assets        
Money market funds and time depositsMoney market funds and time deposits$1,537 $— $— $1,537 $1,584 $— $— $1,584 Money market funds and time deposits$36 $— $— $36 $1,632 $— $— $1,632 
Publicly-held equity securitiesPublicly-held equity securities— — 414 — — 414 Publicly-held equity securities— — 10 — — 10 
Hedging instrumentsHedging instruments— 369 — 369 — 242 — 242 Hedging instruments— 538 — 538 — 394 — 394 
Licensing arrangementsLicensing arrangements— — 280 280 — — 365 365 Licensing arrangements— — 182 182 — — 246 246 
$1,541 $369 $280 $2,190 $1,998 $242 $365 $2,605  $40 $538 $182 $760 $1,642 $394 $246 $2,282 
LiabilitiesLiabilities        Liabilities        
Hedging instrumentsHedging instruments$— $1,120 $— $1,120 $— $1,262 $— $1,262 Hedging instruments$— $966 $— $966 $— $1,071 $— $1,071 
Contingent consideration liabilityContingent consideration liability— — 448 448 — — 196 196 Contingent consideration liability— — 219 219 — — 486 486 
Licensing arrangementsLicensing arrangements— — 297 297 — — 407 407 Licensing arrangements— — 215 215 — — 281 281 
$ $1,120 $745 $1,865 $ $1,262 $603 $1,865  $ $966 $434 $1,400 $ $1,071 $767 $1,838 

Our investments in money market funds and time deposits are classified within Level 1 of the fair value hierarchy because they are valued using quoted market prices. These investments are classified as Cash and cash equivalents within our accompanying unaudited consolidated balance sheets, in accordance with U.S. GAAP and our accounting policies. In addition to $1.537 billion$36 million invested in money market funds and time deposits as of SeptemberJune 30, 20212022 and $1.584$1.632 billion as of December 31, 2020,2021, we held $410$240 million in interest-bearing and non-interest-bearing bank accounts as of SeptemberJune 30, 20212022 and $150$293 million as of December 31, 2020.2021.

Our recurring fair value measurements using Level 3 inputs include those related to our contingent consideration liability. Refer to Note B – Acquisitions, Divestitures and Strategic Investments for a discussion of the changes in the fair value of our contingent consideration liability. In addition, our recurring fair value measurements using Level 3 inputs related to our licensing arrangements, including the contractual right to receive future royalty payments related to the Zytiga™ Drug. We recognizedmaintain a financial asset and associated liability for our licensing arrangements measured at fair value in our accompanying unaudited consolidated balance sheets using the fair value option in accordance with FASB ASC Topic 825, Financial Instruments.

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We own the contractual right Refer to receive 50 percent of the future royalty payments from the licenseeNote E – Hedging Activities and remit such payments to the inventors associated with the intellectual property. Royalty payments we receive reduce the fair value of the financial asset and are presented within Fair Value MeasurementsProceeds from royalty rights, and payments we remit to inventors reduce the fair value of the financial liability and are presented within Payments for royalty rights within our unaudited consolidated statements of cash flows. We sold our right to receive and retain the other 50 percent of the future royalty payments in 2019 for an upfront cash payment, which we accounted for as a secured borrowing in accordance with FASB ASC Topic 860, Transfers and Servicing. Although we sold these rights, we continue to recognize at fair value the future royalty payments as a financial asset and associated liability. Royalty payments associated with the rights we sold no longer impact our cash flows, and we present this activity as Non-cash impact of transferred royalty rights in the supplemental information to our unaudited consolidatedaudited financial statements contained in Item 8 of cash flows. We reduce the fair value of the financial asset and associated liability when such non-cash activity occurs.

We have recorded the fair value of the financial asset and associated liability using a discounted cash flow approach considering the probability-weighted expected future cash flows to be generated by the royalty stream. The fair value of the financial liability also considers the related contractual provisions that govern our payment obligations. Significant increases or decreases in projected cash flows of the royalty stream and the related contractual provisions that govern our payment obligations, discount rates or the time until payment is made would have resulted in a significantly lower or higher fair value measurement of the licensing arrangements' financial asset and liability as of September 30, 2021. However, increases or decreases in the financial asset would be offset by increases or decreases in the financial liability, other thanmost recent Annual Report on Form 10-K for timing of receipt and remittance; as such our earnings are not subject to material gains and losses from the licensing arrangement.additional information.

The recurring Level 3 fair value measurements of our licensing arrangements recognized in our accompanying unaudited consolidated balance sheets as of SeptemberJune 30, 20212022 include the following significant unobservable inputs:
Licensing ArrangementsLicensing ArrangementsFair Value as of September 30, 2021Valuation TechniqueUnobservable InputRangeWeighted Average (1)Licensing ArrangementsFair Value as of June 30, 2022Valuation TechniqueUnobservable InputRange
Weighted Average (1)
Financial AssetFinancial Assettd80 millionDiscounted Cash FlowDiscount Rate15%15%Financial Assettd82 millionDiscounted Cash FlowDiscount Rate15%15%
Projected Year of Payment2021-20252023Projected Year of Payment2022-20252024
Financial LiabilityFinancial Liabilitytd97 millionDiscounted Cash FlowDiscount Rate12 %-15%13%Financial Liabilitytd15 millionDiscounted Cash FlowDiscount Rate12 %-15%13%
Projected Year of Payment2021-20262023Projected Year of Payment2022-20262024
(1)    Unobservable inputs relate to a single financial asset and liability. As such, unobservable inputs were not weighted by the relative fair value of the instruments. For projected year of payment, the amount represents the median of the inputs and is not a weighted average.

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Changes in the fair value of our licensing arrangements' financial asset were as follows:
(in millions)
Balance as of December 31, 20202021$365246 
Proceeds from royalty rights(62)
Non-cash impact of transferred royalty rights(62)(72)
Fair value adjustment (expense) benefit409 
Balance as of SeptemberJune 30, 20212022$280182 

Changes in the fair value of our licensing arrangements' financial liability were as follows:
(in millions)
Balance as of December 31, 20202021$407281 
Payments for royalty rights(85)
Non-cash impact of transferred royalty rights(62)(75)
Fair value adjustment expense (benefit)379 
Balance as of SeptemberJune 30, 20212022$297215 





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Non-Recurring Fair Value Measurements

We hold certain assets and liabilities that are measured at fair value on a non-recurring basis in periods after initial recognition. The fair value of a measurement alternative investment is not estimated if there are no identified events or changes in circumstances that may have a significant adverse effect on the fair value of the investment. Refer to Note B – Acquisitions, Divestitures and Strategic Investments for a discussion of our strategic investments and Note C – Goodwill and Other Intangible Assets for a discussion of the fair values of our intangible assets including goodwill.

The fair value of our outstanding debt obligations was $10.372$8.517 billion as of SeptemberJune 30, 2021, including $1.056 billion relating to our euro-denominated December 2027 Notes,2022 and $10.774$10.196 billion as of December 31, 2020, including $1.118 billion relating to our euro-denominated December 2027 Notes.2021. We determined fair value by using quoted market prices for our publicly registered senior notes, classified as Level 1 within the fair value hierarchy, and face value for commercial paper, term loans and credit facility borrowings outstanding. Refer to Note E – Contractual Obligations and Commitments for a discussion of our debt obligations.


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NOTE E – CONTRACTUAL OBLIGATIONS AND COMMITMENTS

Borrowings and Credit Arrangements

We had total debt outstanding of $9.085$8.971 billion as of SeptemberJune 30, 20212022 and $9.143$9.065 billion as of December 31, 2020,2021, with current maturities of $261$170 million as of SeptemberJune 30, 20212022 and $13$261 million as of December 31, 2020.2021. The debt maturity schedule for our long-term debt obligations is presented below:
(in millions, except interest rates)Issuance DateMaturity DateAs of
Coupon Rate(1)
September 30,
2021
December 31,
2020
May 2022 Notes(3)
May 2015May 2022$— $250 3.375%
October 2023 NotesAugust 2013October 2023244 244 4.125%
March 2024 NotesFebruary 2019March 2024850 850 3.450%
May 2025 NotesMay 2015May 2025523 523 3.850%
June 2025 NotesMay 2020June 2025500 500 1.900%
March 2026 NotesFebruary 2019March 2026850 850 3.750%
December 2027 NotesNovember 2019December 20271,043 1,105 0.625%
March 2028 NotesFebruary 2018March 2028434 434 4.000%
March 2029 NotesFebruary 2019March 2029850 850 4.000%
June 2030 NotesMay 2020June 20301,200 1,200 2.650%
November 2035 Notes(2)
November 2005November 2035350 350 7.000%
March 2039 NotesFebruary 2019March 2039750 750 4.550%
January 2040 NotesDecember 2009January 2040300 300 7.375%
March 2049 NotesFebruary 2019March 20491,000 1,000 4.700%
Unamortized Debt Issuance Discount
and Deferred Financing Costs
2022 - 2049(79)(88)
Unamortized Gain on Fair Value Hedges2023
Finance Lease ObligationVarious
Long-term debt$8,824 $9,130 
(in millions, except interest rates)Issuance DateMaturity DateAs of
Coupon Rate(1)
June 30,
2022
December 31,
2021
October 2023 Senior Notes(4)
August 2013October 2023— 244 4.125%
March 2024 Senior Notes(4)
February 2019March 2024504 850 3.450%
March 2025 Senior Notes(3)
March 2022March 20251,039 — 0.750%
May 2025 Senior Notes(4)
May 2015May 2025— 523 3.850%
June 2025 Senior NotesMay 2020June 2025500 500 1.900%
March 2026 Senior Notes(4)
February 2019March 2026255 850 3.750%
December 2027 Senior Notes(3)
November 2019December 2027935 1,021 0.625%
March 2028 Senior Notes(3)
March 2022March 2028779 — 1.375%
March 2028 Senior Notes(4)
February 2018March 2028344 434 4.000%
March 2029 Senior Notes(4)
February 2019March 2029272 850 4.000%
June 2030 Senior NotesMay 2020June 20301,200 1,200 2.650%
March 2031 Senior Notes(3)
March 2022March 2031779 — 1.625%
March 2034 Senior Notes(3)
March 2022March 2034520 — 1.875%
November 2035 Senior Notes(2)
November 2005November 2035350 350 6.750%
March 2039 Senior Notes(4)
February 2019March 2039450 750 4.550%
January 2040 Senior NotesDecember 2009January 2040300 300 7.375%
March 2049 Senior Notes(4)
February 2019March 2049650 1,000 4.700%
Unamortized Debt Issuance Discount and Deferred Financing Costs2023 - 2049(82)(76)
Unamortized Gain on Fair Value Hedges2022— 
Finance Lease ObligationVarious
Long-term debt$8,802 $8,804 
Note: The table above does not include unamortized amounts related to interest rate contracts designated as cash flow hedges.
(1)    Coupon rates are semi-annual, except for the euro-denominated December 2027 Notes,senior notes, which bear an annual coupon.
(2)    Corporate credit rating improvements may result in a decrease in the adjusted interest rate on our November 2035 Notes to the extent that our lowest credit rating is above BBB- or Baa3. The interest rates on our November 2035 Notes will be permanently reinstated to the issuance rate if the lowest credit ratings assigned to these senior notes is either A- or A3 or higher. Effective November 15, 2021, the interest rate payable will decrease by 0.25 percent and begin accruing at a rate of 6.75 percent following recent upgrades to our credit ratings.
(3)    AsThese notes are euro-denominated and presented in U.S. dollars based on the exchange rate in effect as of SeptemberJune 30, 2022 and December 31, 2021, respectively.
(4)    Amounts repaid, or partially repaid as the case may be, in connection with the March 2022 tender offer and early redemption of certain of our outstanding balance is presentedsenior notes are described below. In addition, in the first quarter of 2022, we repaid $250 million of 3.375% May 2022 Senior Notes classified within Current Debt Obligations within our unaudited consolidated balance sheet.
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Tablesheets as of ContentsDecember 31, 2021.


Revolving Credit Facility

On May 10, 2021, we entered into a new $2.750 billion revolving credit facility (2021 Revolving Credit Facility) with a global syndicate of commercial banks and terminated our previous facility (2018 Revolving Credit Facility). The 2021 Revolving Credit Facility will mature on May 10, 2026, with one-year extension options, subject to certain conditions. This facility provides backing for our commercial paper program, and outstanding commercial paper directly reduces borrowing capacity under the 2021 Revolving Credit Facility. There were no amounts outstanding under the 2021 Revolving Credit Facility as of September
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June 30, 20212022 or December 31, 2021; however, outstanding commercial paper directly reduces borrowing capacity under the 20182021 Revolving Credit Facility as of December 31, 2020.Facility.

Financial Covenant

As of and through SeptemberJune 30, 2021,2022, we were in compliance with the financial covenant required by the credit facilities described above:2021 Revolving Credit Facility.
Covenant RequirementActual
 as of SeptemberJune 30, 20212022as of SeptemberJune 30, 20212022
Maximum permitted leverage ratio(1)
4.003.75 times2.892.61 times
(1)Ratio of total debt to consolidated EBITDA, as defined by the credit agreements, as amended.

The 2021 Revolving Credit Facility includes the following financial covenant requirement for all of our credit arrangements (i)that we maintain the maximum permitted leverage ratio of 4.00 times for the third quarter of 2021, with a step-down to 3.75 times for the fourth quarter of 2021 and through the remaining term. The agreement provides for higher leverage ratios, at our election, for the period following a qualified acquisition at our election, for which consideration exceeds $1.000 billion. In the event of such an acquisition, for the four succeeding quarters immediately following, including the quarter in which the acquisition occurs, the maximum permitted leverage ratio is 4.75 times. The maximum permitted ratio steps down for the fifth, sixth and seventh succeeding quarters to 4.50 times, 4.25 times and 4.00 times, respectively. Thereafter, a maximum leverage ratio of 3.75 times is required through the remaining term of the 2021 Revolving Credit Facility. We have not elected to increase the maximum permitted leverage ratio for the recently completed acquisition of Lumenisqualified acquisitions due to the funding of the acquisition using cash on hand.

The financial covenant requirement provides for an exclusion from the calculation of consolidated EBITDA, as defined by the agreement, through maturity, of any non-cash charges and up to $500 million in restructuring charges and restructuring-related expenses related to our current or future restructuring plans. As of SeptemberJune 30, 2021,2022, we had $428$311 million of the restructuring charge exclusion remaining. In addition, any cash litigation payments (net of any cash litigation receipts), as defined by the agreements,agreement, are excluded from the calculation of consolidated EBITDA, as defined by the agreements,agreement, provided that the sum of any excluded net cash litigation payments do not exceed $1.455 billion in the aggregate. As of SeptemberJune 30, 2021,2022, we had $1.243$1.080 billion of the litigation exclusion remaining.

Any inability to maintain compliance with this covenant could require us to seek to renegotiate the terms of our credit arrangements or seek waivers from compliance with this covenant, both of which could result in additional borrowing costs. Further, there can be no assurance that our lenders would agree to such new terms or grant such waivers on terms acceptable to us. In this case, all 2021 Revolving Credit Facility commitments would terminate, and any amounts borrowed under the facility would become immediately due and payable. Furthermore, any termination of our 2021 Revolving Credit Facility may negatively impact the credit ratings assigned to our commercial paper program, which may impact our ability to refinance any then outstanding commercial paper as it becomes due and payable.

Commercial Paper

Our commercial paper program is backed by the 2021 Revolving Credit Facility, as discussed above, and outstanding commercial paper directly reduces borrowing capacity under the 2021 Revolving Credit Facility. We did not have anyhad $155 million of commercial paper outstanding as of SeptemberJune 30, 2021 or2022 and none as of December 31, 2020.2021.
As of
(in millions, except maturity and yield)June 30, 2022December 31, 2021
Commercial paper outstanding (at par)$155 $— 
Maximum borrowing capacity2,750 2,750 
Borrowing capacity available2,595 2,750 
Weighted average maturity7 days0 days
Weighted average yield1.93 %— %

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Senior Notes

We had senior notes outstanding of $9.143$8.878 billion as of SeptemberJune 30, 20212022 and $9.205$9.121 billion as of December 31, 2020.2021. Our senior notes were issued in public offerings, are redeemable prior to maturity and are not subject to sinking fund requirements. Our senior notes are unsecured, unsubordinated obligations and rank on parity with each other. These notes are effectively junior to liabilities of our subsidiaries (see(refer to Other Arrangements below).

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TableIn March 2022, American Medical Systems Europe B.V. (AMS Europe), an indirect, wholly owned subsidiary of ContentsBoston Scientific, completed a registered public offering (the Offering) of €3.000 billion in aggregate principal amount of euro-dominated senior notes comprised of €1.000 billion of 0.750% Senior Notes due 2025, €750 million of 1.375% Senior Notes due 2028, €750 million of 1.625% Senior Notes due 2031 and €500 million of 1.875% Senior Notes due 2034 (collectively, the Eurobonds). Boston Scientific has fully and unconditionally guaranteed all of AMS Europe's obligations under the Eurobonds, and no other subsidiary of Boston Scientific will guarantee these obligations. AMS Europe is a “finance subsidiary” as defined in Rule 13-01(a)(4)(vi) of Regulation S-X. The financial condition, results of operations and cash flows of AMS Europe are consolidated in the financial statements of Boston Scientific. The Offering resulted in cash proceeds of $3.270 billion, net of investor discounts and issuance costs.

We used the net proceeds from the Offering to fund the tender offer and early redemption of combined aggregate principal amount of $3.275 billion of certain of our outstanding senior notes, as well as to pay accrued interest, tender premiums, fees and expenses. We recorded associated debt extinguishment charges of $194 million in the first quarter of 2022 presented in Interest expense within our accompanying unaudited consolidated statements of operations.

Other Arrangements

We have accounts receivable factoring programs in certain European countries and with commercial banks in China and Japan which include promissory notes discounting programs. We account for our factoring programs as sales under FASB ASC Topic 860, Transfers and Servicing. We have no retained interest in the transferred receivables, other than collection and administration, and once sold, the accounts receivable are no longer available to satisfy creditors in the event of bankruptcy. Amounts de-recognized for accounts and notes receivable, which are excluded from Trade accounts receivable, net inwithin our accompanying unaudited consolidated balance sheets, are aggregated by contract denominated currency below (in millions):
Factoring ArrangementsFactoring ArrangementsAs of September 30, 2021As of December 31, 2020Factoring ArrangementsAs of June 30, 2022As of December 31, 2021
Amount
De-recognized
Weighted Average
Interest Rate
Amount
De-recognized
Weighted Average
Interest Rate
Amount
De-recognized
Weighted Average
Interest Rate
Amount
De-recognized
Weighted Average
Interest Rate
Euro denominatedEuro denominated$152 2.1 %$148 1.9 %Euro denominated$147 1.9 %$141 2.1 %
Yen denominatedYen denominated203 0.5 %240 0.6 %Yen denominated177 0.6 %223 0.6 %
Renminbi denominatedRenminbi denominated— 3.1 %— 3.5 %Renminbi denominated— 3.1 %— 3.2 %

Other Contractual Obligations and Commitments

We had outstanding letters of credit of $135$128 million as of SeptemberJune 30, 20212022 and $124$134 million as of December 31, 2020,2021, which consisted primarily of bank guarantees and collateral for workers' compensation insurance arrangements. As of SeptemberJune 30, 20212022 and December 31, 2020, none of the beneficiaries2021 we had drawn upon the letters of credit or guarantees, and accordingly, we have not recognized a related liability for ourany outstanding letters of credit inwithin our accompanying unaudited consolidated balance sheets as of September 30, 2021 and December 31, 2020.sheets.

Refer to Note F – Contractual Obligations and Commitments to our audited financial statements contained in Item 8 of our most recent Annual Report on Form 10-K for additional information on our borrowings and credit agreements.
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NOTE F – SUPPLEMENTAL BALANCE SHEET INFORMATION

Components of selected captions inwithin our accompanying unaudited consolidated balance sheets are as follows:

Trade accounts receivable, net
As of As of
(in millions)(in millions)September 30, 2021December 31, 2020(in millions)June 30, 2022December 31, 2021
Trade accounts receivableTrade accounts receivable$1,778 $1,637 Trade accounts receivable$2,034 $1,886 
Allowance for credit lossesAllowance for credit losses(108)(105)Allowance for credit losses(117)(108)
$1,669 $1,531  $1,917 $1,778 

The following is a rollforwardroll forward of our Allowance for credit losses:
Three Months Ended September 30,Nine Months Ended
September 30,
Three Months Ended June 30,Six Months Ended
June 30,
(in millions)(in millions)2021202020212020(in millions)2022202120222021
Beginning balanceBeginning balance$107 $94 $105 $74 Beginning balance$113 $101 $108 $105 
Cumulative effect adjustment(1)
n/an/an/a10 
Credit loss expenseCredit loss expense16 20 39 Credit loss expense20 11 
Write-offsWrite-offs(7)(7)(17)(19)Write-offs(5)(4)(11)(10)
Ending balanceEnding balance$108 $103 $108 $103 Ending balance$117 $107 $117 $107 
(1)    Effective January 1, 2020, we adopted

In accordance with FASB ASC Topic 326, Financial Instruments - Credit Losses using the modified retrospective method, which requires that we recognize credit loss reserves when financial assets are established if credit losses are expected over the asset’s contractual life. Refer to Note R – New Accounting Pronouncements to our audited financial statements contained in Item 8 of our most recent Annual Report on Form 10-K for additional information.

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In accordance with FASB(FASB ASC Topic 326,326), we record credit loss reserves to Allowance for credit losses when we establish Trade accounts receivable if credit losses are expected over the asset's contractual life. We base our estimates of credit loss reserves on historical experience and adjust, as necessary, to reflect current conditions using reasonable and supportable forecasts not already reflected in the historical loss information. We utilize an accounts receivable aging approach to determine the reserve to record at accounts receivable commencement for certain customers, applying country or region-specific factors. In performing the assessment of outstanding accounts receivable, regardless of country or region, we may consider significant factors relevant to collectability, including those specific to a customer such as bankruptcy, lengthy average payment cycles and type of account.

We closely monitor outstanding receivables for potential collection risks, including those that may arise from economic and geopolitical conditions. Our sales to government-owned or supported customers, particularly in southern Europe, are subject to an increased number of days outstanding prior to payment relative to other entities, and, in southern Europe, relative to those in other countries. More recently, we have seen an increase in the volume of our U.S. business conducted in ambulatory surgery centers and office-based laboratories. Many of these customers are smaller than those we have historically done business with and may have more limited liquidity. We have adjusted our estimates of credit loss reserves for these customers, regions and conditions based on collection trends.

Inventories
 As of
(in millions)September 30, 2021December 31, 2020
Finished goods$1,039 $893 
Work-in-process127 109 
Raw materials436 349 
 $1,603 $1,351 

Other current assets
 As of
(in millions)September 30, 2021December 31, 2020
Restricted cash and restricted cash equivalents$155 $208 
Derivative assets192 133 
Licensing arrangements142 148 
Other302 263 
 $792 $751 

Property, plant and equipment, net
 As of
(in millions)September 30, 2021December 31, 2020
Land$103 $104 
Buildings and improvements1,340 1,292 
Equipment, furniture and fixtures3,515 3,465 
Capital in progress465 446 
 5,423 5,308 
Less: accumulated depreciation3,314 3,224 
 $2,109 $2,084 

Depreciation expense was $88 million for the third quarter of 2021, $84 million for the third quarter of 2020, $254 million for the first nine months of 2021 and $238 million for the first nine months of 2020.
 As of
(in millions)June 30, 2022December 31, 2021
Finished goods$1,082 $1,029 
Work-in-process144 128 
Raw materials526 452 
 $1,752 $1,610 

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Other current assets
 As of
(in millions)June 30, 2022December 31, 2021
Restricted cash and restricted cash equivalents$132 $188 
Derivative assets286 226 
Licensing arrangements94 132 
Other362 254 
 $874 $799 

Property, plant and equipment, net
 As of
(in millions)June 30, 2022December 31, 2021
Land$118 $109 
Buildings and improvements1,406 1,335 
Equipment, furniture and fixtures3,453 3,475 
Capital in progress537 605 
 5,514 5,525 
Less: accumulated depreciation3,268 3,273 
 $2,246 $2,252 

Depreciation expense was $80 million for the second quarter of 2022, $83 million for the second quarter of 2021, $156 million for the first six months of 2022, and $166 million for the first six months of 2021.

Other long-term assets
As of As of
(in millions)(in millions)September 30, 2021December 31, 2020(in millions)June 30, 2022December 31, 2021
Restricted cash equivalentsRestricted cash equivalents$57 $52 Restricted cash equivalents$50 $55 
Operating lease right-of-use assetsOperating lease right-of-use assets415 458 Operating lease right-of-use assets400 435 
Derivative assetsDerivative assets176 109 Derivative assets252 169 
InvestmentsInvestments434 918 Investments384 412 
Licensing arrangementsLicensing arrangements138 218 Licensing arrangements88 114 
Indemnification assetIndemnification asset163 — 
OtherOther223 166 Other230 225 
$1,444 $1,921  $1,569 $1,410 

Accrued expenses
 As of
(in millions)September 30, 2021December 31, 2020
Legal reserves$357 $505 
Payroll and related liabilities884 681 
Rebates351 331 
Contingent consideration liability253 26 
Other574 656 
 $2,418 $2,197 

Other current liabilities
 As of
(in millions)September 30, 2021December 31, 2020
Deferred revenue$160 $138 
Licensing arrangements142 153 
Taxes payable113 158 
Liabilities held for sale— 200 
Other255 307 
 $669 $958 

Other long-term liabilities
 As of
(in millions)September 30, 2021December 31, 2020
Accrued income taxes$541 $547 
Legal reserves191 64 
Contingent consideration liability195 171 
Licensing arrangements155 253 
Operating lease liabilities377 401 
Deferred revenue296 257 
Other542 615 
 $2,296 $2,309 

 As of
(in millions)June 30, 2022December 31, 2021
Legal reserves$359 $264 
Payroll and related liabilities754 848 
Rebates335 350 
Contingent consideration133 289 
Other615 686 
 $2,197 $2,436 
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Other current liabilities
 As of
(in millions)June 30, 2022December 31, 2021
Deferred revenue$222 $208 
Licensing arrangements112 138 
Taxes payable257 209 
Other193 228 
 $784 $783 

Other long-term liabilities
 As of
(in millions)June 30, 2022December 31, 2021
Accrued income taxes$550 $442 
Legal reserves155 284 
Contingent consideration86 197 
Licensing arrangements103 143 
Operating lease liabilities357 389 
Deferred revenue279 276 
Other458 489 
 $1,988 $2,220 
As a result of our 2019 acquisition of BTG plc. (BTG), we assumed a benefit obligation related to a defined benefit pension plan sponsored by BTG for eligible United Kingdom employees. During the second quarter of 2022, we transferred the benefit obligation and associated assets of the pension plan to third party insurers, and as a result, were relieved from primary responsibility of the benefit obligation and the related plan assets. The transaction did not have a material impact on our financial position or results of operations.

NOTE G – INCOME TAXES

Our effective tax rate from continuing operations is presented below:
Three Months Ended September 30,Nine Months Ended September 30,Three Months Ended June 30,Six Months Ended June 30,
20212020202120202022202120222021
Effective tax rate from continuing operationsEffective tax rate from continuing operations13.2 %31.7 %1.1 %24.3 %Effective tax rate from continuing operations24.7 %(24.9)%26.1 %(11.2)%

The changechanges in our reported tax rates for the thirdsecond quarter and first ninesix months of 2021,2022, as compared to the same periods in 2020, relates2021, relate primarily to the impact of certain receipts and charges that are taxed at different rates than our effective tax rate. These include acquisition/divestiture-related charges and receipts, charges and charges includereceipts on investment portfolio net losses (gains), litigation-related net charges (credits), intangible asset impairment charges, acquisition/divestiture-related net charges, as well as certain discrete tax items primarily related to an IRS audit settlementchanges in the third quarter of 2020.tax laws, unrecognized tax benefits, changes in valuation allowance and foreign return-to-provision adjustments.

As of SeptemberJune 30, 2021,2022, we had $277$411 million of gross unrecognized tax benefits, of which a net $195$333 million, if recognized, would affect our effective tax rate. As of December 31, 2020,2021, we had $261$255 million of gross unrecognized tax benefits, of which a net $183$177 million, if recognized, would affect our effective tax rate. The change in our gross unrecognized tax benefit is primarily related to positions on new entities we acquired through recent acquisitions and restructuring activities.

It is reasonably possible that within the next 12 months, we will resolve multiple issues with foreign, federal and state taxing authorities, resulting in a reduction in our balance of unrecognized tax benefits of up to $23$55 million.

Economic stimulus legislation has been enacted in many countries in response to the COVID-19 pandemic. In the U.S., the CARES Act, enacted on March 27, 2020, provided an estimated $2.2 trillion in COVID-19 pandemic-related relief, and included tax relief and government loans, subsidies and other relief for entities in affected industries. While we have not applied for government loans, we have taken advantage
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Table of the benefits offered in multiple jurisdictions, including the U.S. provision allowing taxpayers to defer payment of the employer portion of certain payroll taxes incurred in 2020. This allowed us to preserve cash generated from operations to service our debt obligations and other near-term commitments and is expected to be paid in full by the end of 2022 as permitted by the legislation.Contents

NOTE H – COMMITMENTS AND CONTINGENCIES

The medical device market in which we participate is largely technology driven. As a result, intellectual property rights, particularly patents and trade secrets, play a significant role in product development and differentiation. Over the years, there has been litigation initiated against us by others, including our competitors, claiming that our current or former product offerings infringe patents owned or licensed by them. Intellectual property litigation is inherently complex and unpredictable. In addition, competing parties frequently file multiple suits to leverage patent portfolios across product lines, technologies and geographies and to balance risk and exposure between the parties. In some cases, several competitors are parties in the same proceeding, or in a series of related proceedings, or litigate multiple features of a single class of devices. These dynamics frequently drive settlement not only for individual cases, but also for a series of pending and potentially related and unrelated cases. Although monetary and injunctive relief is typically sought, remedies and restitution are generally not determined until the conclusion of the trial court proceedings and can be modified on appeal. Accordingly, the outcomes of individual cases are difficult to time, predict or quantify and are often dependent upon the outcomes of other cases in other geographies.

During recent years, we successfully negotiated closure of several long-standing legal matters and have received favorable rulings in several other matters; however, there continues to be outstanding intellectual property litigation. Adverse outcomes in one or more of these matters could have a material adverse effect on our ability to sell certain products and on our operating margins, financial position, results of operations and/or liquidity.

In the normal course of business, product liability, securities and commercial claims are asserted against us. Similar claims may be asserted against us in the future related to events not known to management at the present time. We maintain an insurance policy providing limited coverage against securities claims and we are substantially self-insured with respect to product liability claims and fully self-insured with respect to intellectual property infringement claims. The absence of significant third-party insurance coverage increases our potential exposure to unanticipated claims or adverse decisions. Product liability claims, securities and commercial litigation and other legal proceedings in the future, regardless of their outcome, could have a material adverse effect on our ability to sell certain products and on our operating margins, financial position, results of operations and/or liquidity.
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In addition, like other companies in the medical device industry, we are subject to extensive regulation by national, state and local government agencies in the U.S. and other countries in which we operate. From time to time we are the subject of qui tam actions and governmental investigations often involving regulatory, marketing and other business practices. These qui tam actions and governmental investigations could result in the commencement of civil and criminal proceedings, substantial fines, penalties and administrative remedies and have a material adverse effect on our financial position, results of operations and/or liquidity. For additional information, refer to Note K – Commitments and Contingencies to our audited financial statements contained in Item 8 of our most recent Annual Report on Form 10-K.

In accordance with FASB ASC Topic 450, Contingencies, we accrue anticipated costs of settlement, damages, losses for product liability claims and, under certain conditions, costs of defense, based on historical experience or to the extent specific losses are probable and estimable. Otherwise, we expense these costs as incurred. If the estimate of a probable loss is a range and no amount within the range is more likely, we accrue the minimum amount of the range.

Our accrual for legal matters that are probable and estimable was $548 million as of September 30, 2021 and $569 million as of December 31, 2020 and includes certain estimated costs of settlement, damages and defense primarily related to product liability cases or claims related to our transvaginal surgical mesh products. A portion of this accrual is already funded through our qualified settlement fund (QSF), which is included in restricted cash and restricted cash equivalents in Other current assets of $155 million as of September 30, 2021 and $208 million as of December 31, 2020. Refer to Note F – Supplemental Balance Sheet Information for additional information.

We did not record any litigation-related net charges during the third quarter of 2021 and recorded $302 million during the first nine months of 2021, and $260 million during the third quarter and first nine months of 2020, primarily related to transvaginal mesh products, inclusive of a reserve related to claims made by a coalition of state attorneys general. These settlements were finalized in March of 2021 as described further below.

We record certain legal and product liability charges, credits and costs of defense, which we consider to be unusual or infrequent and significant as Litigation-related net charges (credits) inwithin our accompanying unaudited consolidated financial statements. All other legal and product liability charges, credits and costs are recorded within Selling, general and administrative expenses inwithin our accompanying unaudited consolidated statements of operations. We continue to assess certain litigation and claims to determine the amounts, if any, that management believes will be paid as a result of such claims and litigation and, therefore, additional losses may be accrued and paid in the future, which could materially adversely impact our operating results, cash flows and/or our ability to comply with our financial covenant.

Our accrual for legal matters that are probable and estimable was $514 million as of June 30, 2022 and $548 million as of December 31, 2021 and includes certain estimated costs of settlement, damages and defense primarily related to product liability cases or claims related to our transvaginal surgical mesh products. A portion of this accrual is already funded through our qualified settlement fund (QSF), which is included in restricted cash and restricted cash equivalents in Other current assets of $132 million as of June 30, 2022 and $188 million as of December 31, 2021. Refer to Note F – Supplemental Balance Sheet Information for additional information. We recorded litigation-related net charges of $42 million during the second quarter and first six months of 2022, $298 million during the second quarter of 2021 and $302 million during the first six months of 2021.

During recent years, we successfully negotiated closure of several long-standing legal matters and have received favorable rulings in several other matters; however, there continues to be outstanding litigation. Adverse outcomes in one or more of these matters could have a material adverse effect on our ability to sell certain products and on our operating margins, financial position, results of operations and/or liquidity.

In management's opinion, we are not currently involved in any legal proceedings other than those disclosed in our most recent Annual Report on Form 10-K and those specifically identified below, which, individually or in the aggregate, could have a material adverse effect on our financial condition, operations and/or cash flows. Unless included in our legal accrual or otherwise indicated below, a range of loss associated with any individual material legal proceeding cannot be reasonably estimated.

Patent Litigation

On October 28, 2015, the Company filed suit against Cook Group Limited and Cook Medical LLC (collectively, “Cook”)Cook) in the United States District Court for the District of Delaware (1:15-cv-00980) alleging infringement of certain Company patents regarding Cook’s Instinct™ Endoscopic Hemoclip. The Company seeks lost profits, a reasonable royalty and a permanent injunction. The case was transferred to the District Court for the Southern District of Indiana. Cook filed seven Inter Partes Review (“IPR”)(IPR) requests with the U.S. Patent and Trademark Office (USPTO) against four then-asserted patents, which resulted in the four asserted patents.court staying the case until 2020. All IPRs have concluded and Cook andconfirmed the Company both appealed the Patent Office’s IPR decisions to the Federal Circuit Courtvalidity of Appeals. On April 30, 2020, the U.S. Courtcertain claims of Appeals ruled that claims from two of the Company's patents remain valid, remanding two of the patents for further review by the USPTO’s Patent Trial and Appeal Board. In November 2020, the Patent Office issued remand rulings invalidating several additional claims. The district court stayed the case pending the appeals court decision on the IPRs, which is now complete.each challenged patent. The case is proceeding before the United States District Court for the Southern District of Indiana, with the Company asserting three patents against Cook. Trial is anticipated in February 2023.

On November 20, 2017, The Board of Regents, University of Texas System (UT)Company has also asserted patents against Cook in Germany and TissueGen. Inc., served a lawsuit against us in the Western District of Texas. The complaint against us alleges patent infringement of two U.S. patents owned by UT, relating to “Drug Releasing Biodegradable Fiber Implant” and “Drug Releasing Biodegradable Fiber for Delivery of Therapeutics,” and affects the manufacture, use and sale of our Synergy™ Stent System. On March 12, 2018, the District Court for the Western District of Texas dismissed the action and transferred it to the United States DistrictKingdom. In January 2022, the Düsseldorf Regional Court, forPatent Litigation Chamber ruled that Cook’s Instinct Endoscopic Clip technology infringes the District of Delaware. On September 5, 2019,Company’s patent, EP 3 023 061. The Düsseldorf Court granted an ex parte preliminary injunction giving the Court of Appeals forCompany the Federal Circuit affirmed the dismissal of the District Court forright to enjoin Cook (Cook Medical EUDC GmbH, Germany, Cook
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the Western District of Texas. In April 2020, the United States Supreme Court denied the University’s Petition for Certiorari. UT is proceeding with its case against BSCDeutschland GmbH, Germany and Cook Medical Europe Ltd., Ireland) from offering and selling Instinct Endoscopic Clips in Delaware. Trial is scheduled for November 14, 2022.

On December 9, 2016, the Company and Boston Scientific Neuromodulation Corporation filed a patent infringement action against Nevro in United States District Court for the District of Delaware (16-cv-1163) alleging that ten U.S. patents owned by Boston Scientific Neuromodulation Corporation are infringed by Nevro's Senza™ Spinal Cord Stimulation (SCS) System. At a trial held in October and November 2021 regarding six of Boston Scientific's originally asserted patent claims, a jury granted Boston Scientific a monetary award, finding that each asserted claim is valid, that four of the six claims are infringed by Nevro, and that two of the claims are willfully infringed by Nevro.

On April 21, 2018, the Company and Boston Scientific Neuromodulation Corporation filed a patent infringement, theft of trade secrets and tortious interference with a contract action against Nevro in United States District Court for the District of Delaware (18-cv-664), and amended the complaint on July 18, 2018, alleging that nine U.S. patents owned by Boston Scientific Neuromodulation Corporation are infringed by Nevro’s Senza™ I and Senza™ II SCS Systems. On December 9, 2019, Nevro filed an answer and counterclaims, in which it alleged that our SCS systems infringe five Nevro patents. No trial date has been set for the theft of trade secrets and patent counterclaims. The patent infringement claims from case 18-cv-664 were stayed pending IPRs. On January 6, 2021, the court stayed one of the patent infringement claims from case 16-cv-1163, such that it will proceed with the stayed patent infringement claims from case 18-cv-664.Germany.

Product Liability Litigation

As of October 20, 2021,June 30, 2022, in the United States, approximately 54,50055,000 product liability cases or claims related to transvaginal surgical mesh products designed to treat stress urinary incontinence and pelvic organ prolapse have been asserted against us. Outside the United States, approximately 2,700 cases or claims have been asserted, predominantly in Canada, the United Kingdom, Ireland and Australia. Plaintiffs generally seek monetary damages based on allegations of personal injury associated with the use of our transvaginal surgical mesh products, including design and manufacturing claims, failure to warn, breach of warranty, fraud, violations of state consumer protection laws and loss of consortium claims.

As of October 20, 2021,June 30, 2022, we have entered into master settlement agreements in principle or are in the final stages of entering one with certain plaintiffs' counsel to resolve an aggregate of approximately 52,50053,000 cases and claims in the United States, adjusted to reflect the Company’sCompany's analysis of expected non-participation and duplicate claims. These master settlement agreements provide that the settlement and distribution of settlement funds to participating claimants are conditional upon, among other things, achieving minimum required claimant participation thresholds. Of the approximately 52,50053,000 cases and claims, approximately 50,50052,000 have met the conditions of the settlement and are final. In Canada, we have settled approximately 300 claims. In Australia, the Company has reached a settlement, subject to court approval, that resolves the approximately 2,300 claims asserted in the consolidated class action filed against the Company in the first quarter of 2021. All settlement agreements were entered into solely by way of compromise and without any admission or concession by us of any liability or wrongdoing. The pending cases are in various federal and state courts in

As of June 30, 2022, the U.S. Generally, the plaintiffs allege personal injury associated with use of our transvaginal surgical mesh products. The plaintiffs assert design and manufacturing claims, failure to warn, breach of warranty, fraud, violations of state consumer protection laws and loss of consortium claims. Over 3,100 of the cases were specially assigned to one judge in state court in Massachusetts. On February 7, 2012, the Judicial Panel on Multi-District Litigation (MDL) established MDL-2326 in the U.S. District Court for the Southern District of West Virginia and transferred the federal court transvaginal surgical mesh cases to MDL-2326 for coordinated pretrial proceedings. The Court issued an Order closing the MDL on February 11, 2021, as all cases that had been pending were dismissed or remanded to courts of primary jurisdiction. Outside the United States, there arecompany is facing fewer than 8090 cases and claims in the United Kingdom and Ireland. Canada.

In April 2021 the first quarterCompany's Board of 2021, 2 class actions were filed againstDirectors received a shareholder demand under section 220 of the Delaware General Corporation Law, for inspection of books and records. The Company in Australia. Inhas notified our insurer and retained counsel to respond to the second quarter of 2021, one class action was permanently stayed, while the other is proceeding. The registration process for the class action closed on October 29, 2021. Complete registration information is not yet available but preliminary information indicates that fewer than 300 women have completed registration forms alleging they had Boston Scientific implants. There are also fewer than 10 cases in Canada, inclusive of 1 certified class action, which has settled and received Court approval. demand.

On April 16, 2019, the U.S. Food and Drug Administration (FDA) ordered that all manufacturers of surgical mesh products indicated for the transvaginal repair of pelvic organ prolapse stop selling and distributing their products in the United States immediately, stemming from the FDA’s 2016 reclassification of these devices to class III (high risk) devices, and as a result, the Company ceased global sales and distribution of surgical mesh products indicated for transvaginal pelvic organ prolapse. In AprilFebruary 2021, the Company's BoardMulti-District Litigation (MDL) established in February 2012 by the United States Federal Courts was closed after all pending cases were dismissed or remanded to courts of Directors received a shareholder demand under section 220 of the Delaware General Corporation Law, for inspection of books and records. The Company has notified our insurer and retained counsel to respond to the demand.primary jurisdiction.

We have established a product liability accrual for known and estimated future cases and claims asserted against us as well as with respect to the actions that have resulted in verdicts against us and the costs of defense thereof associated with our transvaginal surgical mesh products. In the second quarter of 2021, we increased the accrual associated with this matter by $298 million to account for increased, post-COVID-19 pandemic settlement and litigation activity related to the remaining cases and claims the Company faces, our revision of the per-case settlement amount for these cases based on recent settlement and litigation activity and changes to our expectations regarding the rate of incoming cases and claims. We continue to engage in discussions with plaintiffs’ counsel regarding potential resolution of pending cases and claims. We continue to vigorously contest the cases and claims asserted against us that do not settle, and expect that more cases will go to trial through 2023. The final resolution of the cases and claims is uncertain and could have a material impact on our results of operations, financial
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condition and/or liquidity. Trials involving our transvaginal surgical mesh products have resulted in both favorable and unfavorable judgments for us. We do not believe that the judgment in any one trial is representative of potential outcomes of all cases or claims related to our transvaginal surgical mesh products.

We are currently named a defendant in 67127 filed product liability cases involving our Greenfield Vena Cava Filter, which we discontinued marketing and activeactively selling in the fourth quarter of 2018, alleging various2018. The plaintiffs assert they are entitled to monetary damages related to alleged injuries, including perforation of the vena cava, post-implant deep vein thrombosis, fracture, and other injuries. Most of the filed cases are part of a consolidated matter in Middlesex County, Massachusetts. We have received notice of an additional 377approximately 325 claims, none of which have been filed. As of October 20, 2021,June 30, 2022, we have entered into master settlement agreements in principle or are in the final stages of entering with certain plaintiffs’plaintiffs' counsel to resolve approximately 200225 cases.

Governmental Investigations and Qui Tam Matters

On December 1, 2015, the Brazilian governmental entity known as CADE (the Administrative Council of Economic Defense), served a search warrant on the offices of our Brazilian subsidiary, as well as on the Brazilian offices of several other major medical device makers who do business in Brazil, in furtherance of an investigation into alleged anti-competitive activity with respect to certain tender offers for government contracts. On June 20, 2017, CADE, through the publication of a “technical note,” announced that it was launching a formal administrative proceeding against Boston Scientific’s Brazilian subsidiary,
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Boston Scientific do Brasil Ltda. (BSB), as well as against the Brazilian operations of Medtronic, Biotronik and St. Jude Medical, two Brazilian associations, ABIMED and AMBIMO and 29 individuals for alleged anti-competitive behavior. Under applicable guidance, BSB could be fined a percentage of BSB’s 2016 gross revenues. In August 2021, the investigating commissioner issued a preliminary recommendation of liability against all of the involved companies, and also recommended that CADE impose fines and penalties. However, on October 25, 2021, the CADE Attorney General's office recommended dismissal of the charges and allegations against BSB and the individual BSB employees who were still individual defendants. Subsequently, on March 30, 2022, the Federal Prosecutor’s office issued a non-binding recommendation that is contrary to the Attorney General’s recommendation.The full Commission is considering this recommendationboth of these recommendations but has not yet issued its decision. We continue to deny the allegations, intend to defend ourselves vigorously and will appeal any decision of liability by the full Commission to the Brazilian courts. During such an appeal, the decision would have no force and effect, and the Court would consider the case without being bound by CADE’s decision.

In March 2022, the Company received a whistleblower letter alleging Foreign Corrupt Practices Act violations in Vietnam. The Company is cooperating with government agencies while investigating these allegations.

Matters Concluded Since December 31, 2021

On May 16, 2018, Arthur Rosenthal et al., filed a plenary summons against Boston Scientific Corporation and Boston Scientific Limited with the High Court of Ireland alleging that payments were due pursuant a transaction agreement regarding Labcoat Limited, a company Boston Scientific purchased in 2008 that provided coating technology for drug-eluting stents. Labcoat sought monetary damages related to an earn-out provision. On March 25, 2022, the parties agreed to a confidential settlement which resolves the dispute. The settlement did not have a material impact on our financial position or results of operations.

On December 21, 2017, Janssen Biotech, Inc., Janssen Oncology, Inc, Janssen Research & Development, LLC,9, 2016, the Company and Johnson & Johnson (collectively, Janssen) were served withBoston Scientific Neuromodulation Corporation filed a qui tam complaint filed on behalf of the United States, 29 states, and the District of Columbia. The complaint, which was filedpatent infringement action against Nevro Corp. (Nevro) in the United States District Court for the Northern District of California, alleges that Janssen violated the federal False Claims Act and state law when providing pricing information for ZYTIGA to the government in connection with direct government sales and government-funded drug reimbursement programs. The case has been transferred to United States District Court for the District of New Jersey.Delaware (16-cv-1163) alleging that ten U.S. patents owned by Boston Scientific Neuromodulation Corporation are infringed by Nevro's Senza™ Spinal Cord Stimulation (SCS) System. The company sought lost profits, a reasonable royalty and a permanent injunction. At a trial held in October and November 2021 regarding six of Boston Scientific's originally asserted patent claims, a jury granted Boston Scientific a monetary award, finding that each asserted claim was valid, that four of the six claims were infringed by Nevro, and that two of the claims were willfully infringed by Nevro. On June 20, 2019,July 29, 2022, the complaint was amendedparties reached a confidential settlement agreement, pursuant to include BTG International Limited aswhich the Company agreed to make a defendant. In May 2020, a class action complaint was filed in New Jersey federal court against Janssenpayment to Nevro of $85 million to resolve all pending litigation between the parties, including this matter and BTG by a direct purchaser of Zytiga on behalf of similarly situated entities. The complaint was amended in February 2021the 18-cv-664 and alleges that BTG and Janssen violated antitrust laws by attempting to enforce certain patents against potential generic competitors. On October 12, 2021, the court granted BTG and Janssen’s motion to compel arbitration in the direct purchaser action and stayed all direct purchaser proceedings. On October 27, 2021, the court granted BTG and Janssen's motion to dismiss all claims in the indirect purchaser action. A motion to dismiss the indirect purchaser and qui tam actions are pending.

Refer to Note G – Income Taxes for information regarding our tax litigation.

Matters Concluded Since December 31, 202021-cv-258 matters described below.

On February 23, 2015, a judge for the Court of Modena (Italy) ordered a trial for Boston Scientific and three of its employees, as well as numerous other defendants charged in criminal proceedings. The charges arise from allegations that the defendants made improper donations to certain healthcare providers and other employees of the Hospital of Modena in order to induce them to conduct unauthorized clinical trials, as well as related government fraud in relation to the financing of such clinical trials. A trial began on February 24, 2016. On November 10, 2017, the Court issued a ruling that convicted one Boston Scientific employee but acquitted two others and levied a fine of €245 thousand against us and imposed joint and several civil damages of €620 thousand on all defendants. We continue to deny these allegations, and timely appealed the decision on May 10, 2018. On November 9, 2020, the Court of Appeal in Bologna reversed the judgements against Boston Scientific and its employee and acquitted them of all charges. This judgment of acquittal became final as toApril 21, 2018, the Company and its employee on April 15, 2021 when the prosecution chose not to appeal.

During the fourth quarter of 2013, we received written discovery requests from certain state attorneys general regarding our transvaginal surgical mesh products and related alleged violations of states’ consumer protection statutes. On December 12,
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2019, the Mississippi Attorney General filed suit against us in a Mississippi state court alleging violations of the Mississippi Consumer Protection Act. In the fourth quarter of 2020 and the first quarter of 2021, we reached settlements with 48 states, including Mississippi, and the District of Columbia. These settlements were finalized in March of 2021.

On September 6, 2019, Boston Scientific Neuromodulation Corporation Boston Scientific Scimed, Inc., and Fortis Advisors, LLC, as a Securityholder Representative for the former Securityholders of nVision Medical Corp. filed a declaratory judgmentpatent infringement, theft of trade secrets and tortious interference with a contract action against BioCardia, Inc.Nevro in the United States District Court for the Northern District of California to address threats and allegations by BioCardia challenging inventorship and ownership of various patents that Boston Scientific Corporation acquired through an April 13, 2018 merger with nVision as well as related threats and allegations by BioCardia of trade secret misappropriation and unjust enrichment. On December 11, 2019, BioCardia filed an amended answer and counterclaims. On April 23, 2020, BioCardia filed a complaint against nVision, which had not been named as a defendant in the original case. On May 22, 2020, BioCardia amended its complaint against nVision to add twenty former nVision shareholders as defendants. On August 20, 2020, BioCardia again amended its complaint against Boston Scientific Corporation/Boston Scientific Scimed, Inc./Fortis Advisors, LLC and its complaint against nVision/nVision shareholders. On April 8, 2021, the parties settled the dispute, and, on April 12, 2021, the parties filed stipulations with the court to dismiss the remaining legal proceedings. We expect the settlement will not result in any material benefit or liability to the Company.

On May 5, 2014, we were served with a subpoena from the U.S. Department of Health and Human Services, Office of the Inspector General. The subpoena seeks information relating to the launch of the Cognis™ CRT-D and Teligen™ ICD line of devices in 2008, the performance of those devices from 2007 to 2009 and the operation of our Physician Guided Learning Program. We are cooperating with this request. On May 6, 2016, a qui tam lawsuit in this matter was unsealed in the United States District Court for the District of Minnesota. AtDelaware (18-cv-664), and amended the same time, we learned that the U.S. federal government and the State of California had earlier declined to intervene in that lawsuit on April 15, 2016. The complaint was served on us on July 21, 2016.18, 2018, alleging that nine U.S. patents owned by Boston Scientific Neuromodulation Corporation were infringed by Nevro’s Senza™ I and Senza™ II SCS Systems. On October 7, 2016, the plaintiff/relator servedDecember 9, 2019, Nevro filed an amended complaintanswer and counterclaims, in which it alleged that dropped the allegations relating to our Physician Guided Learning Program. We filedSCS systems infringed five Nevro patents. Nevro sought lost profits, a motion to dismiss the amended complaint on December 7, 2016reasonable royalty and the court heard our motion to dismiss on April 5, 2017. On August 29, 2017, the Court granted the motion to dismiss, without prejudice and on September 19, 2017, the relator filed a Second Amended Complaint. We filed a motion to dismiss the Second Amended Complaint on October 10, 2017 and the Court denied that motion on December 13, 2017.permanent injunction. On July 31, 2018, the relator filed a motion seeking leave to file a Third Amended Complaint. The Court denied the motion on October 30, 2018. In February 2021, we filed a motion for summary judgment, which the relator opposed, and on August 13, 2021, the Court granted the motion in its entirety. Subsequently,29, 2022, the parties resolved the matter, effective October 4, 2021, and the matter is now concluded. The resolution did not result in any material liabilityagreed to the Company.a confidential settlement, described above.

On November 2, 2020, Koninklijke Philips N.V. and IP2IPO Innovations, Ltd. (“Philips”) servedFebruary 23, 2021, Nevro filed a complaint against the Company in the United States District Court for the District of Delaware.Delaware (21-cv-258). The complaint alleges thatinfringement of five Nevro patents by certain BSC cardiovascular diagnostic devices infringe six Philips patents. Theof the Company’s spinal cord stimulation systems. Nevro sought lost profits, a reasonable royalty and a permanent injunction. On July 29, 2022, the parties have settled the dispute throughagreed to a confidential settlement, agreement.

described above.

NOTE I – STOCKHOLDERS' EQUITY

Preferred Stock

We are authorized to issue 50 million shares of preferred stock in one or more series and to fix the powers, designations, preferences and relative participating, option or other rights thereof, including dividend rights, conversion rights, voting rights, redemption terms, liquidation preferences and the number of shares constituting any series, without any further vote or action by our stockholders.

On May 27, 2020, we completed an offering of 10,062,500 shares of 5.50% Mandatory Convertible Preferred Stock (MCPS), Series A at a price to the public and liquidation preference of $100 per share. The net proceeds from the MCPS offering were
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approximately $975 million after deducting underwriting discounts and commissions and offering expenses. As of SeptemberJune 30, 2021,2022, our MCPS had an aggregate liquidation preference of $1.006 billion.

Holders of MCPS will be entitled to receive, when, as and if declared by our Board of Directors, or an authorized committee thereof, out of funds legally available for payment, cumulative dividends at the annual rate of 5.50% of the liquidation preference of $100 per share, payable in cash or, subject to certain limitations, by delivery of shares of common stock or any combination of cash and shares of common stock, at our election; provided, however, that any unpaid dividends on the MCPS will continue to accumulate as described in the Certificate of Designations.

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Subject to certain exceptions, no dividend or distribution will be declared or paid on shares of our common stock, and no common stock will be purchased, redeemed or otherwise acquired for consideration by us or any of our subsidiaries unless, in each case, all accumulated and unpaid dividends for all preceding dividend periods have been declared and paid, or a sufficient amount of cash or number of shares of common stock has been set apart for the payment of such dividends, on all outstanding shares of MCPS. In the event of our voluntary or involuntary liquidation, winding-up or dissolution, no distribution of our assets may be made to holders of our common stock until we have paid holders of our MCPS, each of which will be entitled to receive a liquidation preference in the amount of $100 per share plus accumulated and unpaid dividends.

Unless earlier converted, each share of MCPS will automatically convert on June 1, 2023, subject to postponement for certain market disruption events, into between 2.3834 and 2.9197 shares of common stock, subject to customary anti-dilution adjustments. The number of shares of common stock issuable upon conversion will be determined based on the average volume-weighted average price per share of common stock over the 20 consecutive trading day period beginning on, and including, the 21st scheduled trading day immediately preceding June 1, 2023.

The MCPS is not subject to any redemption, sinking fund or other similar provisions. However, at our option, we may purchase or exchange the MCPS from time to time in the open market, by tender or exchange offer or otherwise, without the consent of, or notice to, holders of MCPS. The holders of the MCPS will not have any voting rights, with limited exceptions.

In the thirdsecond quarter of 2021,2022, the Audit Committee of our Board of Directors (the Committee), pursuant to authority delegated to such committee by our Board of Directors, declared, and we paid, a cash dividend of $1.375 per MCPS share to holders of our MCPS as of AugustMay 15, 2021,2022, representing a dividend period from JuneMarch 2022 through August 2021.May 2022. On October 26, 2021,July 25, 2022 the Committee declared a cash dividend of $1.375 per MCPS share to holders of our MCPS as of NovemberAugust 15, 2021,2022, representing a dividend period from SeptemberJune through November 2021.August 2022. We have presented cumulative, unpaid dividends within Accrued expenses within our accompanying unaudited consolidated balance sheet as of SeptemberJune 30, 2021.2022.

Refer to Note L – Stockholders' Equity to our audited financial statements contained in Item 8 of our most recent Annual Report on Form 10-K for information on the pertinent rights and privileges of our outstanding common stock.
NOTE J – WEIGHTED AVERAGE SHARES OUTSTANDING

Three Months Ended September 30,Nine Months Ended September 30,Three Months Ended June 30,Six Months Ended June 30,
(in millions)(in millions)2021202020212020(in millions)2022202120222021
Weighted average shares outstanding — basicWeighted average shares outstanding — basic1,423.8 1,430.9 1,421.3 1,413.0 Weighted average shares outstanding — basic1,429.7 1,421.3 1,428.8 1,420.0 
Net effect of common stock equivalentsNet effect of common stock equivalents11.8 — 11.7 — Net effect of common stock equivalents8.1 11.2 9.3 11.7 
Weighted average shares outstanding - assuming dilutionWeighted average shares outstanding - assuming dilution1,435.6 1,430.9 1,433.0 1,413.0 Weighted average shares outstanding - assuming dilution1,437.8 1,432.5 1,438.1 1,431.7 

The following securities were excluded from the calculation of weighted average shares outstanding - assuming dilution because their effect in the periods presented below would have been anti-dilutive:
Three Months Ended September 30,Nine Months Ended September 30,
(in millions)2021202020212020
Common stock equivalents(1)
014014
Stock options outstanding(2)
0636
MCPS(3)
24242411
Three Months Ended June 30,Six Months Ended June 30,
(in millions)2022202120222021
Stock options outstanding(1)
7366
MCPS(2)
24242424
(1)    Represents common stock equivalents pursuant to our employee stock-based compensation plans, which are anti-dilutive in the third quarter and first nine months of 2020 due to our Net loss position in those periods.    
(2)    Represents stock options outstanding pursuant to our employee stock-based compensation plans with exercise prices that were greater than the average fair market value of our common stock for the related periods.
(3)(2)    Represents common stock issuable upon the conversion of MCPS. Refer to Note I – Stockholders' Equity for additional information.

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We base Net income (loss) per common share - assuming dilution upon the weighted-average number of common shares and common stock equivalents outstanding during each year. Potential common stock equivalents are determined using the treasury stock method. We exclude stock options, stock awards and MCPS from the calculation if the effect would be anti-dilutive. The dilutive effect of MCPS is calculated using the if-converted method. The if-converted method assumes that these securities were converted to shares of common stock at the beginning of the reporting period to the extent that the effect is dilutive.

For the thirdsecond quarter and first ninesix months of 2022 and 2021, the effect of assuming the conversion of MCPS into shares of common stock was anti-dilutive, and therefore excluded from the calculation of earnings per share (EPS). Accordingly, Net income was reduced by cumulative Preferred stock dividends, as presented inwithin our accompanying unaudited consolidated statements of operations, for purposes of calculating Net income available to common stockholders.

We issued approximately 3000000less than 1000000 shares of our common stock in the third quarterssecond quarter of 2021 and 2020 and 80000002022, approximately 4000000 shares in the first ninesix months of 2022, approximately 1000000 shares in the second quarter of 2021, and 2020approximately 5000000 shares in the first six months of 2021, following the exercise of stock options, vesting of deferredrestricted stock units or purchases under our employee stock purchase plan. We did not repurchase any shares of our common stock in the first ninesix months of 20212022 or 2020.2021. On December 14, 2020, our Board of Directors approved a new stock repurchase program authorizing the repurchase of up to $1.000 billion of our common stock. As of SeptemberJune 30, 2021,2022, we had the full amount remaining available under the authorization.
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NOTE K – SEGMENT REPORTING

Our 7In the first quarter of 2022, we reorganized our operational structure in order to strengthen our category leadership in the markets we serve and, in particular, benefit our Cardiology customers and patients. Following the reorganization, we have aggregated our core businesses are organized into 32 reportable segments: MedSurg Rhythm and Neuro, and Cardiovascular, each of which represent an aggregation of our operating segments that generategenerates revenues from the sale of medical devices. There was no impact to the reporting units identified for purposes of our annual goodwill impairment testing.

We measure and evaluate our reportable segments based on their respective net sales, of reportable segments, operating income, of reportable segments, excluding intersegment profits, and operating income of reportable segments as a percentage of net sales, all excluding the impact of reportable segments. Operating income of reportable segments as a percentage of net sales of reportable segments is defined as operating income of reportable segments divided by net sales of reportable segments.foreign currency. We exclude from operating income of reportable segments certain corporate-related expenses and certain transactions or adjustments that our chief operating decision maker (CODM) considers to be non-operational, such as amounts related to amortization expense, goodwill and other intangible asset impairment charges, acquisition/divestiture-related net charges (credits), restructuring and restructuring-related net charges (credits); and certain litigation-related net charges (credits) and European Union (EU) Medical Device Regulation (MDR) implementation costs. Although we exclude these amounts from operating income of reportable segments, they are included in reported Income (loss) before income taxes inwithin our accompanying unaudited consolidated statements of operations and are included in the reconciliation below. Refer to Note L – Revenue for net sales by reportable segment presented in accordance with U.S. GAAP.

A reconciliation of the totals reported for the reportable segments to the applicable line items within our accompanying unaudited consolidated statements of operations is as follows (in millions, except percentages):
Three Months Ended
September 30,
Nine Months Ended
September 30,
2021202020212020
MedSurg$917 $825$2,725 $2,175
Rhythm and Neuro819 7572,436 1,985
Cardiovascular1,196 1,0023,588 2,862
Total net sales of reportable segments2,932 2,5848,748 7,021
All other (Specialty Pharmaceuticals)(1)
— 7413 183
Net sales$2,932 $2,659$8,761 $7,204
. We have revised prior periods to conform to the current year presentation.

Three Months Ended
June 30,
Six Months Ended
June 30,
Net Sales2022202120222021
MedSurg$1,278 $1,185$2,442 $2,233
Cardiovascular2,066 1,8653,967 3,526
Total net sales of reportable segments3,344 3,0506,410 5,758
Specialty Pharmaceuticals(1)
— — 13
Impact of foreign currency fluctuations(100)27(140)58
$3,244 $3,077$6,270 $5,829
Income (loss) before income taxes
MedSurg$398 $403$769 $748
Cardiovascular543 5291,020 989
Total operating income of reportable segments941 9321,789 1,736
Specialty Pharmaceuticals(1)
— — 4
Unallocated amounts:
Corporate expenses, including hedging activities and impact of foreign currency fluctuations on operating income of reportable segments(123)(159)(189)(298)
Intangible asset impairment charges, acquisition/divestiture-related net charges (credits), restructuring and restructuring-related net charges (credits), and certain litigation-related net charges (credits) and EU MDR implementation costs(192)(331)(308)(445)
Amortization expense(204)(180)(402)(365)
Operating income (loss)423 262889 632
Other expense, net(78)(113)(388)(157)
Income (loss) before income taxes$345 $149$501 $474
(1) On March 1, 2021, we completed the divestiture of the Specialty Pharmaceuticals business. Prior to the divestiture, we presented the Specialty Pharmaceuticals business as a standalone operating segment alongside our reportable segments.
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Three Months Ended
September 30,
Nine Months Ended
September 30,
2021202020212020
MedSurg$338 $307$1,033 $738
Rhythm and Neuro160 165476 296
Cardiovascular361 2081,117 593
Total operating income of reportable segments859 6802,626 1,628
All other (Specialty Pharmaceuticals)(1)
— 49124
Unallocated amounts:
Corporate expenses, including hedging activities(109)(108)(438)(330)
Intangible asset impairment charges, acquisition/divestiture-related net charges (credits), restructuring and restructuring-related net charges (credits), and certain litigation-related net charges (credits) and EU MDR implementation costs(178)(629)(624)(957)
Amortization expense(184)(197)(549)(595)
Operating income (loss)387 (205)1,019 (130)
Other expense, net95 (22)(62)(256)
Income (loss) before income taxes$483 $(227)$957 $(386)
(1) On March 1, 2021, we completed the divestiture of the Specialty Pharmaceuticals business. Our consolidated net sales and income (loss) before income taxes for the first nine months of 2021 include Specialty Pharmaceuticals up to the date of the closing of the transaction.
Operating income margin of reportable segmentsThree Months Ended
September 30,
Nine Months Ended
September 30,
2021202020212020
MedSurg36.8 %37.2 %37.9 %33.9 %
Rhythm and Neuro19.5 %21.9 %19.5 %14.9 %
Cardiovascular30.2 %20.8 %31.1 %20.7 %


Three Months Ended June 30,Six Months Ended
June 30,
Operating income margin of reportable segments2022202120222021
MedSurg31.2 %34.0 %31.5 %33.5 %
Cardiovascular26.3 %28.4 %25.7 %28.0 %

NOTE L – REVENUE

We generate revenue primarily from the sale of single-use medical devices and present revenue net of sales taxes inwithin our accompanying unaudited consolidated statements of operations. The following tables disaggregateIn the first quarter of 2022, we reorganized our revenue from contracts with customers by business structure into 5 operating segments and geographic region (in millions):
Three Months Ended September 30,
20212020
BusinessesU.S.Int'lTotalU.S.Int'lTotal
Endoscopy$306 $227 $533 $270 $205 $475 
Urology and Pelvic Health275 109 384 251 99 350 
Cardiac Rhythm Management312 199 512 275 190 465 
Electrophysiology32 55 86 33 43 76 
Neuromodulation175 46 221 176 41 216 
Interventional Cardiology376 368 744 255 331 586 
Peripheral Interventions250 202 452 236 179 416 
Specialty Pharmaceuticals— — — 65 10 74 
Net Sales$1,726 $1,206 $2,932 $1,560 $1,098 $2,659 

Onon March 1, 2021, we completed the divestiture of the Specialty Pharmaceuticals business. Our consolidated net sales for the first ninesix months of 2021 include Specialty Pharmaceuticals up to the date of the closing of the transaction. The following tables disaggregate our revenue from contracts with customers by component and geographic region (in millions). We have revised prior periods to conform to current year presentation:

Three Months Ended June 30,
20222021
BusinessesU.S.Int'lTotalU.S.Int'lTotal
Endoscopy$338 $221 $560 $316 $235 $551 
Urology and Pelvic Health320 130 450 285 112 397 
Neuromodulation186 53 239 194 53 247 
MedSurg844 404 1,248 794 400 1,195 
   Interventional Cardiology Therapies192 382 574 206 369 574 
   Watchman225 25 250 192 24 216 
   Cardiac Rhythm Management342 199 541 314 210 524 
    Electrophysiology73 79 152 34 62 95 
Cardiology832 685 1,517 746 664 1,410 
Peripheral Interventions257 221 478 260 213 473 
Cardiovascular1,089 906 1,996 1,005 877 1,883 
Total Net Sales$1,933 $1,311 $3,244 $1,800 $1,277 $3,077 

Six Months Ended June 30,
20222021
BusinessesU.S.Int'lTotalU.S.Int'lTotal
Endoscopy$650 $441 $1,091 $596 $454 $1,050 
Urology and Pelvic Health606 257 863 542 216 758 
Neuromodulation346 101 448 345 99 444 
MedSurg1,602 799 2,402 1,483 769 2,252 
Interventional Cardiology Therapies378 740 1,118 400 699 1,100 
Watchman428 48 476 341 45 386 
Cardiac Rhythm Management667 394 1,061 590 403 993 
Electrophysiology123 147 270 64 115 179 
Cardiology1,596 1,329 2,925 1,395 1,263 2,658 
Peripheral Interventions513 430 944 498 407 906 
Cardiovascular2,109 1,760 3,868 1,893 1,670 3,564 
Specialty Pharmaceuticals   10 4 13 
Total Net Sales$3,711 $2,559 $6,270 $3,386 $2,443 $5,829 

Refer to Note K- Segment Reporting for information on our reportable segments.

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Nine Months Ended September 30,
20212020
BusinessesU.S.Int'lTotalU.S.Int'lTotal
Endoscopy$902 $681 $1,583 $715 $550 $1,265 
Urology and Pelvic Health817 325 1,142 650 260 910 
Cardiac Rhythm Management903 603 1,505 738 515 1,253 
Electrophysiology96 169 265 86 116 202 
Neuromodulation520 145 666 426 103 529 
Interventional Cardiology1,117 1,113 2,230 741 973 1,714 
Peripheral Interventions748 609 1,358 649 499 1,148 
Specialty Pharmaceuticals10 13 162 21 183 
Net Sales$5,112 $3,649 $8,761 $4,167 $3,037 $7,204 
Three Months Ended June 30,Six Months Ended June 30,
Regions2022202120222021
U.S.$1,933 $1,800 $3,711 $3,376 
Europe, Middle East and Africa660 662 1,284 1,266 
Asia-Pacific530 520 1,047 994 
Latin America and Canada120 95 228 180 
Medical Devices3,244 3,077 6,270 5,816 
U.S.— — — 10 
International— — — 
Specialty Pharmaceuticals— — — 13 
Total Net Sales$3,244 $3,077 $6,270 $5,829 
Emerging Markets(1)
$427 $359 $817 $676 

(1)
Three Months Ended September 30,Nine Months Ended September 30,
Geographic Regions2021202020212020
U.S.$1,726 $1,496 $5,103 $4,005 
EMEA (Europe, Middle East and Africa)590 540 1,855 1,507 
APAC (Asia-Pacific)517 472 1,511 1,292 
LACA (Latin America and Canada)99 77 279 217 
Medical Devices2,932 2,584 8,748 7,021 
U.S.— 65 10 162 
International— 10 21 
Specialty Pharmaceuticals— 74 13 183 
Net Sales$2,932 $2,659 $8,761 $7,204 
Emerging Markets(1)
$354 $291 $1,030 $832 
(1)    We define Emerging Markets as the 20 countries that we believe have strong growth potential based on their economic conditions, healthcare sectors and our global capabilities. Periodically, we assess our list of Emerging Markets countries, and effective January 1, 2021, modified our list to includewhich currently includes the following countries: Brazil, Chile, China, Colombia, Czech Republic, India, Indonesia, Malaysia, Mexico, Philippines, Poland, Russia, Saudi Arabia, Slovakia, South Africa, South Korea, Taiwan, Thailand, Turkey and Vietnam. We have revised prior period amounts to conform to the current year's presentation which had an immaterial impact on previously reported Emerging Markets net sales.

Deferred Revenue

Contract liabilities are classified within Other current liabilities and Other long-term liabilities inwithin our accompanying unaudited consolidated balance sheets. Our deferred revenue balance was $455$501 million as of SeptemberJune 30, 20212022 and $395$484 million as of December 31, 2020.2021. Our contractual liabilities are primarily composed of deferred revenue related to the LATITUDE™ Patient Management System within our Cardiac Rhythm Management (CRM)Cardiology business, for which revenue is recognized over the average service period based on device and patient longevity. Our contractual liabilities also include deferred revenue related to the LUX-Dx™ Insertable Cardiac Monitor (ICM) system, also within our CRMCardiology business, for which revenue is recognized over the average service period based on device longevity and usage. We recognized revenue of $39$35 million in the thirdsecond quarter and $113$76 million in the first ninesix months of 20212022 that was included in the above contract liability balance as of December 31, 2020.2021. We have elected not to disclose the transaction price allocated to unsatisfied performance obligations when the original expected contract duration is one year or less. In addition, we have not identified material unfulfilled performance obligations for which revenue is not currently deferred.

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Variable Consideration

We generally allowFor additional information on variable consideration, refer to Note A – Significant Accounting Policies to our customers to return defective, damaged and,audited financial statements contained in certain cases, expired products for credit. We baseItem 8 of our estimate for sales returns upon historical trends and record the amount as a reduction to revenue when we sell the initial product. In addition, we may allow customers to return previously purchased products for next-generation product offerings. For these transactions, we defer recognition of revenuemost recent Annual Report on the sale of the earlier generation product based upon an estimate of the amount of product to be returned when the next-generation products are shipped to the customer. Uncertain timing of next-generation product approvals, variability in product launch strategies, product recalls and variation in product utilization all affect our estimates related to sales returns and could cause actual returns to differ from these estimates.
Form 10-K.
We also offer sales rebates and discounts to certain customers. We treat sales rebates and discounts as a reduction of revenue and classify the corresponding liability as current. We estimate rebates for products where there is sufficient historical information available to predict the volume of expected future rebates. If we are unable to reasonably estimate the expected rebates, we record a liability for the maximum rebate percentage offered. We have entered certain agreements with group purchasing organizations to sell our products to participating hospitals at negotiated prices. We recognize revenue from these agreements following the same revenue recognition criteria discussed above.

NOTE M – CHANGES IN OTHER COMPREHENSIVE INCOME

The following tables provide the reclassifications out of Other comprehensive income (loss), net of tax:

Three Months Ended September 30
(in millions)Foreign Currency Translation AdjustmentsNet Change in Derivative Financial InstrumentsNet Change in Defined Benefit Pensions and Other ItemsTotal
Balance as of June 30, 2021$136 $146 $(46)$237 
Other comprehensive income (loss) before reclassifications(47)61 — 14 
(Income) loss amounts reclassified from accumulated other comprehensive income(2)(11)— (13)
Total other comprehensive income (loss)(49)50 — 
Balance as of September 30, 2021$88 $196 $(46)$238 

(in millions)Foreign Currency Translation AdjustmentsNet Change in Derivative Financial InstrumentsNet Change in Defined Benefit Pensions and Other ItemsTotal
Balance as of June 30, 2020$(46)$222 $(45)$131 
Other comprehensive income (loss) before reclassifications88 (50)— 38 
(Income) loss amounts reclassified from accumulated other comprehensive income(5)(14)— (19)
Total other comprehensive income (loss)84 (64)— 20 
Balance as of September 30, 2020$38 $158 $(45)$151 










(in millions)Foreign Currency Translation AdjustmentsNet Change in Derivative Financial InstrumentsNet Change in Defined Benefit Pensions and Other ItemsTotal
Balance as of March 31, 2022$29 $229 $(36)$222 
Other comprehensive income (loss) before reclassifications79 165 — 245 
(Income) loss amounts reclassified from accumulated other comprehensive income(2)(31)(34)
Total other comprehensive income (loss)77 134 — 211 
Balance as of June 30, 2022$106 $363 $(36)$433 

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Nine Months Ended September 30
(in millions)Foreign Currency Translation AdjustmentsNet Change in Derivative Financial InstrumentsNet Change in Defined Benefit Pensions and Other ItemsTotal
Balance as of March 31, 2021$134 $165 $(45)$254 
Other comprehensive income (loss) before reclassifications(12)(0)(8)
(Income) loss amounts reclassified from accumulated other comprehensive income(3)(6)— (9)
Total other comprehensive income (loss)(18)— (16)
Balance as of June 30, 2021$136 $146 $(46)$237 

(in millions)Foreign Currency Translation AdjustmentsNet Change in Derivative Financial InstrumentsNet Change in Defined Benefit Pensions and Other ItemsTotal
Balance as of December 31, 2020$218 $36 $(47)$207 
Other comprehensive income (loss) before reclassifications182 188 
(Income) loss amounts reclassified from accumulated other comprehensive income(1)
(135)(21)— (157)
Total other comprehensive income (loss)(130)161 31 
Balance as of September 30, 2021$88 $196 $(46)$238 
(1)    In connection with the completion of the divestiture of the Specialty Pharmaceuticals business in the first quarter of 2021, we released $127 million of cumulative translation adjustments associated with the disposed business from Accumulated other comprehensive income (loss), net of tax.

(in millions)(in millions)Foreign Currency Translation AdjustmentsNet Change in Derivative Financial InstrumentsNet Change in Defined Benefit Pensions and Other ItemsTotal(in millions)Foreign Currency Translation AdjustmentsNet Change in Derivative Financial InstrumentsNet Change in Defined Benefit Pensions and Other ItemsTotal
Balance as of December 31, 2019$142 $173 $(45)$270 
Balance as of December 31, 2021Balance as of December 31, 2021$93 $206 $(36)$263 
Other comprehensive income (loss) before reclassificationsOther comprehensive income (loss) before reclassifications(90)36 — (54)Other comprehensive income (loss) before reclassifications17 200 217 
(Income) loss amounts reclassified from accumulated other comprehensive income(Income) loss amounts reclassified from accumulated other comprehensive income(14)(52)— (65)(Income) loss amounts reclassified from accumulated other comprehensive income(4)(43)(47)
Total other comprehensive income (loss)Total other comprehensive income (loss)(104)(15)— (119)Total other comprehensive income (loss)13 157 — 170 
Balance as of September 30, 2020$38 $158 $(45)$151 
Balance as of June 30, 2022Balance as of June 30, 2022$106 $363 $(36)$433 

(in millions)Foreign Currency Translation AdjustmentsNet Change in Derivative Financial InstrumentsNet Change in Defined Benefit Pensions and Other ItemsTotal
Balance as of December 31, 2020$218 $36 $(47)$207 
Other comprehensive income (loss) before reclassifications53 121 174 
(Income) loss amounts reclassified from accumulated other comprehensive income(1)
(134)(10)— (144)
Total other comprehensive income (loss)(81)111 30 
Balance as of June 30, 2021$136 $146 $(46)$237 
(1) In connection with the completion of the divestiture of the Specialty Pharmaceuticals business in the first quarter of 2021, we released $127 million of cumulative translation adjustments associated with the disposed business from Accumulated other comprehensive income (loss), net of tax.

Refer to Note D – Hedging Activities and Fair Value Measurements for further detail on our net investment hedges recorded in Foreign currency translation adjustments and our cash flow hedges recorded in Net change in derivative financial instruments.

The gains and losses on defined benefit and pension items before reclassifications and gains and losses on defined benefit and pension items reclassified from Accumulated other comprehensive income (loss), net of tax were reduced by immaterial income tax impacts in the third quarter and first nine months of 2021 and 2020.

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NOTE N – NEW ACCOUNTING PRONOUNCEMENTS

Periodically, new accounting pronouncements are issued by the FASB or other standard setting bodies. Recently issued standards typically do not require adoption until a future effective date. Prior to their effective date, we evaluate the pronouncements to determine the potential effects of adoption on our accompanying unaudited consolidated financial statements. During the first quartersix months of 2021,2022, we implemented the following standards, which did not have a material impact on our financial position and results of operations.

ASC Update No. 2020-10

In October 2020, the FASB issued ASC Update No. 2020-10, Codification Improvements. Update No. 2020-10 amends a wide variety of Topics in the Codification in order to improve the consistency of the Codification and the application thereof, while leaving Generally Accepted Accounting Principles unchanged.

ASC Update No. 2020-06

In August 2020, the FASB issued ASC Update No. 2020-06, Debt - Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging - Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity. The amendments in Update No. 2020-06 simplify the complexity associated with applying U.S. GAAP for certain financial instruments with characteristics of liabilities and equity. More specifically, the amendments focus on the guidance for convertible instruments and derivative scope exception for contracts in an entity’s own equity.

ASC Update No. 2019-12

In December 2019, the FASB issued ASC Update No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes. The purpose of Update No. 2019-12 is to continue the FASB’s Simplification Initiative to reduce complexity in accounting standards. The amendments in Update No. 2019-12 simplify the accounting for income taxes by removing certain exceptions related to the incremental approach for intraperiod tax allocation, the requirement to recognize or derecognize deferred tax liabilities related to equity method investments that are also foreign subsidiaries, and the methodology for calculating income taxes in an interim period. In addition to removing these exceptions, Update No. 2019-12 also clarifies and simplifies other aspects of the accounting for income taxes.

Standards to be Implemented

ASC Update No. 2021-08

In October 2021, the FASB issued ASC Update No. 2021-08, Business Combinations (Topic 805): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers. The amendments in Update No. 2021-08 improve the accounting for acquired revenue contracts with customers in a business combination by addressing diversity in practice and inconsistency related to recognition of an acquired contract liability and payment terms and their effect on subsequent revenue recognized by the acquirer. Update No. 2021-08 is effective for fiscal years beginning after December 15, 2022, including interim periods within those fiscal years. Early adoption is permitted, and we plan to adopt Update No. 2021-08 during the fourth quarter of 2021. We have the option to apply the amendments retrospectively to all business combinations for which the acquisition date occurs on or after the beginning of the fiscal year that includes the interim period of early adoption, or prospectively. We do not expect the adoption to have a material effect on our financial position or results of operations.

ASC Update No. 2021-05

In July 2021, the FASB issued ASC Update No. 2021-05, Leases (Topic 842): Lessors—Certain Leases with Variable Lease Payments. The amendments in Update No. 2021-05 revise lessor lease classification guidance and require accounting for certain leases with variable lease payments that do not depend on a reference index or rate as operating leases. Such
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classification is required if the lease would have been classified as a sales-type or direct financing lease in accordance with guidance in FASB ASC Topic 842 and the lessor would have otherwise recognized a day-one loss. Update No. 2021-05 is effective for fiscal years beginning after December 15, 2021, including interim periods within those fiscal years. We haveadopted Update No. 2021-05 in the optionfirst quarter of 2022 on a prospective basis.

Standards to applybe Implemented

In March 2022, the amendments retrospectivelyFASB issued ASC Update No. 2022-01, Derivatives and Hedging (Topic 815): Fair Value Hedging - Portfolio Layer Method. Update No. 2022-01 expands the current single-layer method to leases that commenced or were modifiedallow multiple hedged layers of a single closed portfolio under the method, among other updates to these methods. Update No. 2022-01 is effective for fiscal years beginning after December 15, 2022, and interim periods within those fiscal years. Early adoption is permitted on any date on or after the issuance of this update for any entity that has adopted the amendments in Update No. 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities, for the corresponding period. We do not expect the adoption to have a material impact on our financial position or results of operations.

In March 2022, the FASB issued ASC Update No. 2022-02, Financial Instruments- Credit Losses (Topic 326: Troubled Debt Restructurings and Vintage Disclosures. Update No. 2022-02 makes amendments related to troubled debt restructurings for entities that have adopted Update No. 2016-13, Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments, as well as amendments related to vintage disclosures for entities with investments in financing receivables that have adopted Update No. 2016-13. Update No. 2022-02 is effective for fiscal years beginning after December 15, 2022, and interim periods within those fiscal years. Update No. 2022-02 should be applied prospectively, with the option of modified retrospective adoption for the recognition and measurement of troubled debt restructurings. Early adoption is permitted on any date on or after the issuance of this update for any entity that has adopted the amendments in Update No. 2016-13. We do not expect the adoption to have a material impact on our financial position or results of operations.

In June 2022, the FASB issued ASC Update No. 2022-03, Fair Value Measurement (Topic 820): Fair Value Measurement of Equity Securities Subject to Contractual Sale Restrictions. Update No. 2022-03 clarifies the guidance in Topic 842,820 related to measuring the fair value of an equity security subject to contractual restrictions that prohibit the sale of an equity security, as well as introduces new disclosure requirements for these types of equity securities. Update No. 2022-03 is effective for fiscal years beginning after December 15, 2023, including interim periods within those fiscal years. Early adoption is permitted for both interim and annual financial statements that have not yet been issued or made available for issuance and the amendments in this update should be applied prospectively. We do not expect the adoption to have a material impact on our financial position or results of operations.

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No other new accounting pronouncements issued or effective in the period had or are expected to have a material impact on our accompanying unaudited consolidated financial statements.

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ITEM 2.MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS

Introduction

Boston Scientific Corporation is a global developer, manufacturer and marketer of medical devices that are used in a broad range of interventional medical specialties. Our mission is to transform lives through innovative medical solutions that improve the health of patients around the world. As a medical technology leader for more than 40 years, we have advanced the practice of less-invasive medicine by helping physicians and other medical professionals diagnose and treat a wide range of diseases and medical conditions and improve patients’ quality of life by providing alternatives to surgery and other medical procedures that are typically traumatic to the body. Our net sales have increased substantially since our formation, fueled in part by strategic acquisitions designed to improve our ability to take advantage of growth opportunities in the medical device industry and to build diversified portfolios within our core businesses. We advance science for life by providing a broad range of high performance solutions to address unmet patient needs and reduce the cost of healthcare. When used in this report, the terms "we," "us," "our,""our" and "the Company" mean Boston Scientific Corporation and its divisions and subsidiaries.

COVID-19 Pandemic

In December 2019, the novel strain of coronavirus (SARS-Cov-2), and its disease commonly known as COVID-19 (COVID-19), was reported in China and has since widely impacted the global public health and economic environment. In March 2020, the World Health Organization (WHO) declared COVID-19, including all additional variations and strains thereof, a global pandemic (COVID-19 pandemic). While the majority of procedures using our products are deferrable, most of the conditions that we treat are generally fairly acute and cannot be deferred for extended periods. As the pandemic spread worldwide and with COVID-19 cases confirmed in all major geographies, many elective and semi-emergent procedures were postponed, enabling hospital staff to focus critical resources on caring for COVID-19 patients.

The ongoing COVID-19 pandemic and accompanying restrictions negatively impacted our net sales and our results of operations beginning in March 2020. We experienced improvement in our global sales trends beginning in the third quarter of 2020 which continued through the third quarter of 2021, as procedure volumes resumed and referral rates improved. During the third quarter of 2021, as the more contagious Delta variant strain surged globally, elective procedures were unfavorably impacted in certain regions, particularly in the U.S., while they improved in many parts of the globe as COVID-19 vaccines were increasingly made available. However, COVID-19 cases persist in many locations around the world where vaccination rates remain low and new, more contagious variant strains of COVID-19 have emerged, resulting in continued restrictions. In particular, certain countries within our Asia Pacific region, including India and Japan, as well as Latin America have been significantly impacted. These restrictions continued to negatively impact our net sales in the first nine months of 2021. The timing and success of efforts to distribute and administer COVID-19 vaccines to these locations and to broad portions of the worldwide population, enabling widespread immunity to COVID-19, will continue to have an impact on the duration and extent of the pandemic and its effect on demand for our products.

Because the severity, magnitude, and duration of the COVID-19 pandemic and its economic consequences continue to be uncertain, the pandemic’s impact on our operations and financial performance, as well as its impact on our ability to execute our business strategies and initiatives successfully, remains uncertain and difficult to predict. Procedural delays from the further resurgence of COVID-19 infections and the emergence of new, more contagious variant strains of COVID-19, as well as laborstaffing shortages within healthcare facilities, have and may continue to negatively impact demand for our products, net sales, gross profit margin and operating expenses as a percentage of net sales. In addition,

While we expect the COVID-19 pandemic and related impacts will continue to negatively impact our performance to an extent, we continue to believe our long-term fundamentals remain strong and we intend to manage through these challenges with strategic focus and the winning spirit of our global team.

Economic Trends

Economic conditions created in part by the COVID-19 pandemic, the economic recovery that has followed in many areashave had, and other macroeconomic factorsare expected to continue to have, led to a challenging labor market in which we compete, which affectsnegative impact on our ability to retain and attract new talent as well as put inflationary pressure on certain operational costs due to wage increases. Further, webusiness. We face and mayexpect to continue to face, increases in the cost and limited availability of raw materials, components, and other inputs necessary to manufacture and distribute our products due to constraints and inflation within the global supply chain, as well as increases in the cost and time to distribute our products.

We continue Further, other macroeconomic factors have led to focusa challenging labor market in which we compete, which impacts in some cases, our effortsability to retain and attract new talent as well as put inflationary pressure on certain operational costs due to wage increases. Uncertainty around inflationary pressures, rising interest rates and monetary policy, could potentially cause new, or exacerbate existing, economic challenges that we may face. These conditions could worsen, or others could arise, if the healthU.S. and safety of patients, healthcare providers and employees, while executing our mission of transforming lives through innovative medical solutionsglobal economies were to improve the health of patients around the world. Since the onset of the COVID-19 pandemic, our global crisis management team has focused on protecting our employees and customers, optimizing our operations and securing our supply chain. We have successfully implemented business continuity plans including establishing a medical advisory group for employees, leveraging work from home infrastructureenter recessionary periods, triggered or exacerbated by monetary policy designed to facilitate social distancing and accelerating capabilities to provide remote physician support. In certain locations where the COVID-19 transmission rates are low or moderate, as defined by public health experts, employees are returning to the office. We will continue to be guided by our values and mission and monitor our return-to-office strategy based on science and data for the
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health and safety of our employees. While we expect the COVID-19 pandemic will continue to negatively impact our 2021 performance to an extent,we continue to believe our long-term fundamentals remain strong and we will manage through these challenges with strategic focus and the winning spirit of our global team.curb inflation.

Corporate Sustainability

Our sustainable economic, environmental, social and socialgovernance practices underpin all aspects of our global business. Our approach is aligned with the United Nations Sustainable Development Goals and our material topics and practices are informed by a broad range of internal and external stakeholders – locally, nationally and globally. Our employees around the world work with suppliers and other organizations that share our commitment to these practices that help address issues related to health inequity, economic disparity, climate change and environmental protection. These efforts are supported by our cross-functional Corporate Social Responsibility Steering Committee, our Corporate Social Responsibility Council, our Environmental Health and Safety teams and policies, our Global Council for Inclusion, as well as our local, regional and national employee and community engagement programs. Key examplesIn addition, our 2021 annual bonus plan included performance measured against environmental targets, employee engagement goals and human capital metrics targets, including global gender and U.S. (inclusive of our programs include setting measurable, transparent diversity, equity and inclusion (DE&I)Puerto Rico) multicultural goals. Our “3UP by 2023” initiative furthers our focus on increasing the representation of women and multicultural talent at the supervisor and manager level by three percentage points or more by December 31, 2022. Our DE&I progress has been recognized in 2021 whenIn 2022 we were ranked innamed to the Top 10Forbes 2022 list of America's Best Employers for Diversity, as well as ranked number one among Health Care Equipment companies on renewable energy use by Forbes, namedJUST Capital. We were also ranked on the JUST Capital Top 100 list of Companies Supporting Healthy Families100 best Corporate Citizens of 2022 by 3BL Media. For additional information on our sustainability efforts, as well as our Diversity, Equity and Communities and recognized as a "Best PlaceInclusion (DE&I) initiatives, refer to Workour most recent Annual Report on Form 10-K. For additional information on our annual bonus plan, refer to our Proxy Statement for Disability Inclusion", achieving top marks on Disability:IN’s 2021 Disability Equality Index (DEI). We are also proactively addressing ways to minimize energy consumption, carbon emissions, waste management and water use. We are focused on a “C3” strategy: Cutting energy use, Converting to renewable energy sources and Compensating with carbon offset projects where needed. We are on track to carbon neutrality in our manufacturing and key distribution sites by 2030, and expect to fully source or generate our electricity from renewable sources by 2024.the 2022 Annual Meeting of Shareholders.


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Financial Summary

Three Months Ended SeptemberJune 30, 20212022

Our net sales for the thirdsecond quarter of 20212022 were $2.932$3.244 billion, as compared to $2.659$3.077 billion for the thirdsecond quarter of 2020.2021. This increase of $274$167 million, or 10.35.4 percent, included operational1 net sales growth of 9.79.6 percent and the positivenegative impact of 60420 basis points from foreign currency fluctuations, and includes net sales from our recent acquisitions following the respective dates of acquisition.1fluctuations. The increase in our net sales was primarily driven by recent acquisitions as well as the recoverystrength and diversity of electiveour product portfolio coupled with growth in the underlying markets in which we compete and semi-emergent procedure volumes compared to the prior year when the COVID-19 pandemic had significant impact on our net sales.strong commercial execution. Refer to Quarterly Results and Business Overview for a discussion of our net sales by global business.

Our reported net income available to common stockholders for the thirdsecond quarter of 20212022 was $405$246 million, or $0.28$0.17 per diluted share. Our reported results for the thirdsecond quarter of 20212022 included certain charges and/or credits totaling $176$389 million (after-tax), or $0.12$0.27 per diluted share. Excluding these items, adjusted net income available to common stockholders for the third quarter of 20211 was $581$635 million, or $0.41$0.44 per diluted share.1, 2

Our reported net lossincome available to common stockholders for the thirdsecond quarter of 20202021 was $169$172 million, or $(0.12)$0.12 per diluted share. Our reported results for the thirdsecond quarter of 20202021 included certain charges and/or credits totaling $698$405 million (after-tax), or $0.48$0.28 per diluted share. Excluding these items, adjusted net income available to common stockholders for the third quarter of 20201 was $530$577 million, or $0.37$0.40 per diluted share.
1
































1Operational net sales growth rates, which exclude the impact of foreign currency fluctuations, and other adjusted measures, which exclude certain items required by generally accepted accounting principles in the United States (U.S. GAAP) are not prepared in accordance with U.S. GAAP and should not be considered in isolation from, or as a replacement for, the most directly comparable GAAP measure. Refer to Additional Information for a discussion of management’s use of these non-GAAP financial measures.

2In May 2020, we completed an offering of 10,062,500 shares of 5.50% Mandatory Convertible Preferred Stock, Series A (MCPS) at a price to the public and liquidation preference of $100 per share. Refer to the reconciliations below for the impact of the MCPS cumulative preferred stock dividends on our calculations of earnings per share (EPS).
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The following is a reconciliation of our results of operations prepared in accordance with U.S. GAAP to those adjusted results considered by management. Refer to Quarterly Results and Business Overview and Additional Information for a discussion of these reconciling items:
Three Months Ended September 30, 2021 Three Months Ended June 30, 2022
(in millions, except per share data)(in millions, except per share data)Income (Loss) Before Income TaxesIncome Tax Expense (Benefit)Net Income (Loss)Preferred Stock DividendsNet Income (Loss) Available to Common Stockholders
Impact per Share(3)
(in millions, except per share data)Income (Loss) Before Income TaxesIncome Tax Expense (Benefit)Net Income (Loss)Preferred Stock DividendsNet Income (Loss) Available to Common Stockholders
Impact per Share(2)
ReportedReported$483 $64 $419 $(14)$405 $0.28 Reported$345 $85 $260 $(14)$246 $0.17 
Non-GAAP adjustments:Non-GAAP adjustments:Non-GAAP adjustments:
Amortization expenseAmortization expense184 16 168 — 168 0.12 Amortization expense204 29 175 — 175 0.12 
Intangible asset impairment charges128 19 109 — 109 0.08 
Goodwill and other intangible asset impairment chargesGoodwill and other intangible asset impairment charges— — 0.00 
Acquisition/divestiture-related net charges (credits)Acquisition/divestiture-related net charges (credits)(232)(2)(230)— (230)(0.16)Acquisition/divestiture-related net charges (credits)91 (5)95 — 95 0.07 
Restructuring and restructuring-related net charges (credits)Restructuring and restructuring-related net charges (credits)44 39 — 39 0.03 Restructuring and restructuring-related net charges (credits)35 30 — 30 0.02 
Litigation-related net charges (credits)Litigation-related net charges (credits)— — — — — (0.00)Litigation-related net charges (credits)42 10 33 — 33 0.02 
Investment portfolio net losses (gains)Investment portfolio net losses (gains)26 19 — 19 0.01 Investment portfolio net losses (gains)— 0.00 
European Union (EU) Medical device regulation (MDR) implementation costsEuropean Union (EU) Medical device regulation (MDR) implementation costs13 12 — 12 0.01 European Union (EU) Medical device regulation (MDR) implementation costs17 14 — 14 0.01 
Debt extinguishment chargesDebt extinguishment charges— 0.00 
Deferred tax expenses (benefits)Deferred tax expenses (benefits)— (43)43 — 43 0.03 Deferred tax expenses (benefits)— (34)34 — 34 0.02 
Discrete tax itemsDiscrete tax items— (17)17 — 17 0.01 Discrete tax items— (1)— (1)(0.00)
AdjustedAdjusted$646 $51 $595 $(14)$581 $0.41 Adjusted$744 $95 $649 $(14)$635 $0.44 
(3)
 Three Months Ended June 30, 2021
(in millions, except per share data)Income (Loss) Before Income TaxesIncome Tax Expense (Benefit)Net Income (Loss)Preferred Stock DividendsNet Income (Loss) Available to Common Stockholders
Impact per Share(2)
Reported$149 $(37)$186 $(14)$172 $0.12 
Non-GAAP adjustments:
Amortization expense180 19 161 — 161 0.11 
Goodwill and other intangible asset impairment charges45 39 — 39 0.03 
Acquisition/divestiture-related net charges (credits)(64)(65)— (65)(0.05)
Restructuring and restructuring-related net charges (credits)39 35 — 35 0.02 
Litigation-related net charges (credits)298 69 229 — 229 0.16 
Investment portfolio net losses (gains)— 0.00 
European Union (EU) Medical device regulation (MDR) implementation costs12 11 — 11 0.01 
Deferred tax expenses (benefits)— (25)25 — 25 0.02 
Discrete tax items— 35 (35)— (35)(0.02)
Adjusted$665 $74 $591 $(14)$577 $0.40 











(2) For the thirdsecond quarter and first six months of 2022 and 2021, the effect of assuming the conversion of MCPS into shares of common stock was anti-dilutive, and therefore excluded from the calculation of EPS. Accordingly, GAAP Net incomeand Adjusted net income were reduced by cumulative Preferred stock dividends, as presented in our unaudited consolidated statements of operations, for purposes of calculating GAAP Net income available to common stockholders.


 Three Months Ended September 30, 2020
(in millions, except per share data)Income (Loss) Before Income TaxesIncome Tax Expense (Benefit)Net Income (Loss)Preferred Stock DividendsNet Income (Loss) Available to Common Stockholders
Impact per Share(4)
Reported$(227)$(72)$(155)$(14)$(169)$(0.12)
Non-GAAP adjustments:
Amortization expense197 21 176 — 176 0.12 
Intangible asset impairment charges219 30 189 — 189 0.13 
Acquisition/divestiture-related net charges (credits)111 24 87 — 87 0.06 
Restructuring and restructuring-related net charges (credits)23 21 — 21 0.01 
Litigation-related net charges (credits)260 255 — 255 0.18 
Investment portfolio net losses (gains)(65)(15)(50)— (50)(0.03)
European Union (EU) Medical device regulation (MDR) implementation costs— 0.00 
Deferred tax expenses (benefits)— (18)18 — 18 0.01 
Discrete tax items— (3)— (3)(0.00)
Adjusted$525 $(18)$543 $(14)$530 $0.37 
(4) For the third quarter of 2020, the effect of assuming the conversion of MCPS into shares of common stock was anti-dilutive, and therefore excluded from the calculation of EPS. Accordingly, GAAP Net loss and Adjusted net loss were reduced by cumulative Preferred stock dividends, as presented in our unaudited consolidated statements of operations, for purposes of calculating EPS. We have assumed dilution of 13.6 million common stock equivalents related to employee stock options for all or a portion of the non-GAAP adjustments, which were anti-dilutive for GAAP purposes due to our Net loss position.







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NineSix Months Ended SeptemberJune 30, 20212022

Our net sales for the first ninesix months of 20212022 were $8.761$6.270 billion, as compared to $7.204$5.829 billion for the first ninesix months of 2020.2021. This increase of $1.557 billion,$441 million, or 21.67.6 percent, included operational1 net sales growth of 19.311.1 percent and the positivenegative impact of 230350 basis points from foreign currency fluctuations, and includes net sales from our recent acquisitions following the date of acquisition.fluctuations. The increase in our net sales was primarily driven by recent acquisitions as well as the recoverystrength and diversity of electiveour product portfolio coupled with growth in the underlying markets in which we compete and semi-emergent procedure volumes compared to the prior year when the COVID-19 pandemic had significant impact on our net sales.strong commercial execution. Refer to Quarterly Results and Business Overview for a discussion of our net sales by global business.

Our reported net income available to common stockholders for the first ninesix months of 20212022 was $905$342 million, or $0.63$0.24 per diluted share. Our reported results for the first ninesix months of 20212022 included certain charges and/or credits totaling $778$854 million (after-tax), or $0.54$0.59 per diluted share. Excluding these items, adjusted net income available to common stockholders1 for the first ninesix months of 20212022 was $1.683$1.197 billion, or $1.17$0.83 per diluted share.

Our reported net lossincome available to common stockholders for the first ninesix months of 20202021 was $311$500 million, or $(0.22)$0.35 per diluted share. Our reported results for the first ninesix months of 20202021 included certain charges and/or credits totaling $1.351 billion$602 million (after-tax), or $0.95$0.42 per diluted share. Excluding these items, adjusted net income available to common stockholders1 for the first ninesix months of 20202021 was $1.040$1.102 billion, or $0.73$0.77 per diluted share.





































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The following is a reconciliation of our results of operations prepared in accordance with U.S. GAAP to those adjusted results considered by management. Refer to Quarterly Results and Business Overview and Additional Information for a discussion of these reconciling items:
Nine Months Ended September 30, 2021
(in millions, except per share data)Income (Loss) Before Income TaxesIncome Tax Expense (Benefit)Net Income (Loss)Preferred Stock DividendsNet Income (Loss) Available to Common Stockholders
Impact per Share(5)
Reported$957 $10 $946 $(42)$905 $0.63 
Non-GAAP adjustments:
Amortization expense549 53 496 — 496 0.35 
Intangible asset impairment charges173 25 148 — 148 0.10 
Acquisition/divestiture-related net charges (credits)(444)(449)— (449)(0.31)
Restructuring and restructuring-related net charges (credits)133 15 118 — 118 0.08 
Litigation-related net charges (credits)302 69 233 — 233 0.16 
Investment portfolio net losses (gains)178 43 136 — 136 0.09 
European Union (EU) Medical device regulation (MDR) implementation costs35 32 — 32 0.02 
Deferred tax expenses (benefits)— (86)86 — 86 0.06 
Discrete tax items— 21 (21)— (21)(0.01)
Adjusted$1,883 $158 $1,725 $(42)$1,683 $1.17 

Six Months Ended June 30, 2022
(in millions, except per share data)Income (Loss) Before Income TaxesIncome Tax Expense (Benefit)Net Income (Loss)Preferred Stock DividendsNet Income (Loss) Available to Common Stockholders
Impact per Share(2)
Reported$501 $131 $370 $(28)$342 $0.24 
Non-GAAP adjustments:
Amortization expense402 56 345 — 345 0.24 
Intangible asset impairment charges— — 0.00 
Acquisition/divestiture-related net charges (credits)163 (5)167 — 167 0.12 
Restructuring and restructuring-related net charges (credits)64 55 — 55 0.04 
Litigation-related net charges (credits)42 10 33 — 33 0.02 
Investment portfolio net losses (gains)11 — 0.00 
European Union (EU) Medical device regulation (MDR) implementation costs33 28 — 28 0.02 
Debt extinguishment charges194 45 149 — 149 0.10 
Deferred tax expenses (benefits)— (63)63 — 63 0.04 
Discrete tax items— — — — — 0.00 
Adjusted$1,416 $191 $1,224 $(28)$1,197 $0.83 
(5) For the first nine months of 2021, the effect of assuming the conversion of MCPS into shares of common stock was anti-dilutive, and therefore excluded from the calculation of EPS. Accordingly, GAAP
Six Months Ended June 30, 2021
(in millions, except per share data)Income (Loss) Before Income TaxesIncome Tax Expense (Benefit)Net Income (Loss)Preferred Stock DividendsNet Income (Loss) Available to Common Stockholders
Impact per Share(2)
Reported$474 $(53)$527 $(28)$500 $0.35 
Non-GAAP adjustments:
Amortization expense365 37 328 — 328 0.23 
Goodwill and other intangible asset impairment charges45 39 — 39 0.03 
Acquisition/divestiture-related net charges (credits)(212)(219)— (219)(0.15)
Restructuring and restructuring-related net charges (credits)88 10 79 — 79 0.05 
Litigation-related net charges (credits)302 69 233 — 233 0.16 
Investment portfolio net losses (gains)152 35 117 — 117 0.08 
European Union (EU) Medical device regulation (MDR) implementation costs23 20 — 20 0.01 
Deferred tax expenses (benefits)— (43)43 — 43 0.03 
Discrete tax items— 38 (38)— (38)(0.03)
Adjusted$1,237 $108 $1,129 $(28)$1,102 $0.77 
Net loss
and Adjusted net income were reduced by cumulative Preferred stock dividends, as presented in our unaudited consolidated statements of operations, for purposes of calculating GAAP Net income available to common stockholders.


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Nine Months Ended September 30, 2020
(in millions, except per share data)Income (Loss) Before Income TaxesIncome Tax Expense (Benefit)Net Income (Loss)Preferred Stock DividendsNet Income (Loss) Available to Common Stockholders
Impact per Share(6)
Reported$(386)$(94)$(292)$(19)$(311)$(0.22)
Non-GAAP adjustments:
Amortization expense595 62 533 — 533 0.38 
Intangible asset impairment charges452 68 384 — 384 0.27 
Acquisition/divestiture-related net charges (credits)148 48 100 — 100 0.07 
Restructuring and restructuring-related net charges (credits)77 10 66 — 66 0.05 
Litigation-related net charges (credits)260 255 — 255 0.18 
Investment portfolio net losses (gains)(65)(15)(50)— (50)(0.04)
European Union (EU) Medical device regulation (MDR) implementation costs20 17 — 17 0.01 
Deferred tax expenses (benefits)— (26)26 — 26 0.02 
Discrete tax items— (20)20 — 20 0.01 
Adjusted$1,100 $41 $1,059 $(19)$1,040 $0.73 
(6) For the first nine months of 2020, the effect of assuming the conversion of MCPS into shares of common stock was anti-dilutive, and therefore excluded from the calculation of EPS. Accordingly, GAAP Net loss and Adjusted net income were reduced by cumulative Preferred stock dividends, as presented in our unaudited consolidated statements of operations, for purposes of calculating EPS. We have assumed dilution of 14.1 million common stock equivalents related to employee stock options for all or a portion of the non-GAAP adjustments, which were anti-dilutive for GAAP purposes due to our Net loss position.
Cash provided by operating activities was $1,392 million for the first nine months of 2021. As of September 30, 2021, we had total debt outstanding of $9.085 billion net of unamortized debt issuance discounts and deferred financing costs, Cash and cash equivalents of $1.947 billion and working capital of $2.207 billion. Refer to Liquidity and Capital Resources for further discussion.


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Quarterly Results and Business Overview

In the first quarter of 2022, we reorganized our operational structure and have aggregated our core businesses, each of which generate revenues from the sale of medical devices (Medical Devices), into two reportable segments: MedSurg and Cardiovascular. Within the Cardiovascular segment, the newly formed Cardiology division represents the combined former Rhythm Management and Interventional Cardiology divisions. We have revised prior periods to conform to the current year presentation. The following section describes our net sales and results of operations by reportable segment and business unit. For additional information on our businesses and product offerings, seerefer to Item 1. Business of our most recent Annual Report on Form 10-K.
Three Months Ended September 30, Three Months Ended June 30,
(in millions)(in millions)20212020Change(in millions)20222021Increase/(Decrease)
EndoscopyEndoscopy$533 $475 12.1%Endoscopy$560 $551 1.6%
Urology and Pelvic HealthUrology and Pelvic Health384 350 9.9%Urology and Pelvic Health450 397 13.4%
NeuromodulationNeuromodulation239 247 (3.4)%
MedSurgMedSurg917 825 11.2%MedSurg1,248 1,195 4.5%
Cardiac Rhythm Management512 465 10.1%
Electrophysiology86 76 13.6%
Neuromodulation221 216 2.4%
Rhythm and Neuro819 757 8.2%
Interventional Cardiology744 586 26.9%
CardiologyCardiology1,517 1,410 7.6%
Peripheral InterventionsPeripheral Interventions452 416 8.8%Peripheral Interventions478 473 1.2%
CardiovascularCardiovascular1,196 1,002 19.4%Cardiovascular1,996 1,883 6.0%
Medical DevicesMedical Devices2,932 2,584 13.5%Medical Devices3,244 3,077 5.4%
Specialty Pharmaceuticals(7)
 74 (100.0)%
Net SalesNet Sales$2,932 $2,659 10.3%Net Sales$3,244 $3,077 5.4%
Six Months Ended June 30,
(in millions)(in millions)20222021Increase/(Decrease)
EndoscopyEndoscopy$1,091 $1,050 3.9%
Urology and Pelvic HealthUrology and Pelvic Health863 758 13.9%
NeuromodulationNeuromodulation448 444 0.7%
MedSurgMedSurg2,402 2,252 6.6%
CardiologyCardiology2,925 2,658 10.0%
Peripheral InterventionsPeripheral Interventions944 906 4.2%
CardiovascularCardiovascular3,868 3,564 8.6%
Medical DevicesMedical Devices6,270 5,816 7.8%
Specialty Pharmaceuticals(3)
Specialty Pharmaceuticals(3)
 13 (100.0)%
Net SalesNet Sales$6,270 $5,829 7.6%

(3)
Nine Months Ended September 30,
(in millions)20212020Change
Endoscopy$1,583 $1,265 25.1%
Urology and Pelvic Health1,142 910 25.5%
MedSurg2,725 2,175 25.3%
Cardiac Rhythm Management1,505 1,253 20.1%
Electrophysiology265 202 31.4%
Neuromodulation666 529 25.7%
Rhythm and Neuro2,436 1,985 22.7%
Interventional Cardiology2,230 1,714 30.1%
Peripheral Interventions1,358 1,148 18.3%
Cardiovascular3,588 2,862 25.4%
Medical Devices8,748 7,021 24.6%
Specialty Pharmaceuticals(7)
13 183 (92.7)%
Net Sales$8,761 $7,204 21.6%
(7) On March 1, 2021, we completed the divestiture of the Specialty Pharmaceuticals business. Our consolidated net sales include Specialty Pharmaceuticals up to the date of the closing of the transaction.

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MedSurg

Endoscopy

Our Endoscopy business develops and manufactures devices to diagnose and treat a broad range of gastrointestinal (GI) and pulmonary conditions with innovative, less-invasive technologies. Our net sales of Endoscopy products were $533$560 million for the thirdsecond quarter of 2021 and $1.583$1.091 billion for the first ninesix months of 20212022, and represented 1817 percent of our consolidated net sales in both the third quarter and first nine months of 2021.periods. Our Endoscopy net sales increased $57$9 million, or 12.11.6 percent, in the thirdsecond quarter of 2021 and increased $318$41 million, or 25.13.9 percent, in the first ninesix months of 2021,2022, compared to the prior year periods. In the thirdsecond quarter of 2021,2022, this increase included operational net sales growth of 11.45.8 percent and a positivenegative impact of 60430 basis points from foreign currency fluctuations, compared to the prior year period. In the first ninesix months of 2021,2022, this increase included operational net sales growth of 22.67.3 percent and a positivenegative impact of 250340 basis points from foreign currency fluctuations, compared to the prior year period.

Operational net sales This growth in the third quarter and first nine months of 2021 was primarily driven by our biliary, single-use imaging franchise led by our EXALTTM D Single-use Duodenoscope and our biliary franchise led by our AXIOSTM Stent and Delivery System, as well as our hemostasis and infection prevention franchises due to the recovery of elective and semi-emergent procedure volumes compared to the prior year, particularly in the first half, when the COVID-19 pandemic had a significant negative impact on our net sales.franchises.

Urology and Pelvic Health

Our Urology and Pelvic Health business develops and manufactures devices to treat various urological and pelvic conditions for both male and female anatomies. Our net sales of Urology and Pelvic Health products were $384$450 million for the thirdsecond quarter of 2021 and $1.142 billion$863 million for the first ninesix months of 2021,2022, representing 1314 percent of our consolidated net sales in both the third quarter and first nine months of 2021.periods. Our Urology and Pelvic Health net sales increased $35$53 million, or 9.913.4 percent, in the thirdsecond quarter of 2021 and increased $232$105 million, or 25.513.9 percent, in the first ninesix months of 2021,2022, compared to the prior year periods. In the thirdsecond quarter of 2021,2022, this increase included operational net sales growth of 9.416.2 percent and a positivenegative impact of 50280 basis points from foreign currency fluctuations, compared to the prior year period. In the first ninesix months of 2021,2022, this increase included operational net sales growth of 23.716.1 percent and a positivenegative impact of 180220 basis points from foreign currency fluctuations, compared to the prior year period.

Operational net sales growth included organic net sales growth of 6.67.0 percent in the second quarter of 2022 and 7.0 percent in the first six months of 2022, and the positive impact of 920 basis points in both periods, from our acquisition of the surgical business of Lumenis, LTD. (Lumenis) in the third quarter of 2021 and 23.6 percent in the first nine months of 2021, and the positive impact of 280 basis points in the third quarter of 2021 and 20 basis points in the first nine months of 2021 due to our Lumenis, LTD. (Lumenis) acquisition and the divestiture of the Intrauterine Health business in the second quarter of 2020. In the third quarter of 2021, we completed the acquisition of the global surgical business of Lumenis, a privately held company that develops and commercializes energy-based medical solutions, including innovative laser systems, fibers and accessories used for urology and otolaryngology procedures.2021. Organic net sales growth was driven by strong performance across our stone managementkey products, including our LithoVue™ Single-Use Digital Flexible Ureteroscopes and prostate health franchises and, during the first nine months of 2021, our prosthetic urology franchise due to the recovery of elective and semi-emergent procedure volumes compared to the prior year when the COVID-19 pandemic had a significant negative impact on our net sales.

Rhythm and Neuro

Cardiac Rhythm Management

Our Cardiac Rhythm Management (CRM) business develops and manufactures a variety of implantable devices that monitor the heart and deliver electricity to treat cardiac abnormalities. Our net sales of CRM products were $512 million for the third quarter of 2021 and $1.505 billion for the first nine months of 2021, representing 17 percent of our consolidated net sales in both the third quarter and first nine months of 2021. Our CRM net sales increased $47 million, or 10.1 percent, in the third quarter of 2021 and increased $252 million, or 20.1 percent, in the first nine months of 2021, compared to the prior year periods. In the third quarter of 2021, this increase included operational net sales growth of 9.6 percent and a positive impact of 50 basis points from foreign currency fluctuations, compared to the prior year period. In the first nine months of 2021, this increase included operational net sales growth of 17.7 percent and a positive impact of 240 basis points from foreign currency fluctuations, compared to the prior year period.

Operational net sales growth included organic net sales declines of (0.3) percent in the third quarter of 2021 and growth of 8.8 percent for the first nine months of 2021, and the positive impact of 990 basis points in the third quarter of 2021 and 890 basis points for the first nine months of 2021 from the acquisition of Preventice Solutions, adding to our CRM business a full
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portfolio of mobile cardiac health solutions and services, ranging from ambulatory cardiac monitors, to cardiac event monitors and mobile cardiac telemetry. During the third quarter of 2021, organic sales performance was driven by a decline in net sales from our defibrillator franchise partially offset by growth in our pacemaker franchise and cardiac diagnostics franchise, led by our LUX-Dx™ Insertable Cardiac Monitor (ICM) system. For the first nine months of 2021, organic net sales growth was attributable to our defibrillator and pacemaker franchises, due to the recovery of semi-emergent and emergent procedure volumes compared to the prior year, particularly in the first half, when the COVID-19 pandemic had a significant negative impact on our net sales,SpaceOAR™ Hydrogel Systems, as well as our cardiac diagnostics franchise, led by our ICM system.

Electrophysiology

Our Electrophysiology business develops and manufactures less-invasive medical technologies used in the diagnosis and treatment of rate and rhythm disorders of the heart. Our net sales of Electrophysiology products were $86 million for the third quarter of 2021 and $265 million for the first nine months of 2021, representing three percent of our consolidated net sales in both the third quarter and first nine months of 2021. Our Electrophysiology net sales increased $10 million, or 13.6 percent, in the third quarter of 2021 and increased $63 million, or 31.4 percent, in the first nine months of 2021, compared to the prior year periods. In the third quarter of 2021, this increase included operational net sales growth of 13.2 percent and a positive impact of 40 basis points from foreign currency fluctuations, compared to the prior year period. In the first nine months of 2021, this increase included operational net sales growth of 27.8 percent and a positive impact of 350 basis points from foreign currency fluctuations, compared to the prior year period.

Operational net sales growth was driven primarily by the recovery of elective procedure volumes compared to the prior year, particularly in the first half, when the COVID-19 pandemic had a significant negative impactcontinued focus on our net sales, as well as the success of our ongoing POLARx™ Cryoablation System and Stablepoint Force-Sensing Catheter international launches.globalization.

Neuromodulation

Our Neuromodulation business develops and manufactures devices to treat various neurological movement disorders and manage chronic pain. Our net sales of Neuromodulation products were $221$239 million for the thirdsecond quarter of 2021 and $666$448 million for the first ninesix months of 2021,2022, representing eight7 percent of our consolidated net sales in both the third quarter and first nine months of 2021.periods. Our Neuromodulation net sales increased $5decreased $8 million, or 2.43.4 percent in the thirdsecond quarter of 2021 and increased $136$3 million, or 25.70.7 percent in the first ninesix months of 2021,2022, compared to the prior year periods. In the thirdsecond quarter of 2021,2022, this increasedecrease included an operational net sales growthdecline of 2.11.0 percent and a positivenegative impact of 30240 basis points from foreign currency fluctuations, compared to the prior year period. In the first ninesix months of 2021,2022, this increase included operational net sales growth of 24.12.8 percent and a positivenegative impact of 160210 basis points from foreign currency fluctuations, compared to the prior year period.

Operational net sales declines for the second quarter of 2022 were primarily due to very strong procedural volumes in the second quarter of 2021 associated with sharp recovery from the COVID-19 pandemic as well as the U.S. launch of our WaveWriter Alpha™ SCS and Vercise Genus™ DBS systems. Operational net sales growth for the first six months of 2022 was primarily driven by the first quarter performance of our spinal cord stimulation (SCS) systems, led by our next generation WaveWriter Alpha™ SCS System. During the first nine monthssystems.
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Table of 2021, growth was driven by sales of both our SCS systems and our deep brain stimulation (DBS) systems, including our Vercise Genus™ DBS System, due to the recovery of elective procedure volumes in the first half of 2021 compared to the prior year when the COVID-19 pandemic had a more significant negative impact on our net sales. During the third quarter of 2021, procedure volumes continued to be negatively impacted by the COVID-19 pandemic due to their elective nature.Contents


Cardiovascular

Interventional Cardiology

Our Interventional Cardiology business develops and manufactures devices and medical technologies for diagnosing and treating coronary artery diseasea variety of diseases and structural heart conditions.abnormalities of the heart. Our net sales of Interventional Cardiology products were $744 million$1.517 billion for the thirdsecond quarter of 2021 and $2.230$2.925 billion for the first ninesix months of 2021,2022, representing 2547 percent of our consolidated net sales in both the third quarter and first nine months of 2021.periods. Our Interventional Cardiology net sales increased $158$108 million, or 26.97.6 percent, in the thirdsecond quarter of 2021 and increased $516$266 million, or 30.110.0 percent in the first ninesix months of 2021,2022, compared to the prior year periods. In the thirdsecond quarter of 2021,2022, this increase included operational net sales growth of 26.012.5 percent and a positivenegative impact of 90480 basis points from foreign currency fluctuations, compared to the prior year period. In the first ninesix months of 2021,2022, this increase included operational net sales growth of 27.414.1 percent and a positivenegative impact of 270410 basis points from foreign currency fluctuations, compared to the prior year period. Operational net sales growth included organic net sales growth of 8.5 percent in the second quarter of 2022 and 9.7 percent for the first six months of 2022, and the positive impact of 400 and 440 basis points, respectively, from our acquisitions of Preventice Solutions, Inc. (Preventice), Farapulse, Inc. and Baylis Medical in the first and third quarter of 2021 and the first quarter of 2022, respectively.

In the third quarter and first nine months of 2021, operationalOrganic net sales growth was primarily driven by our WATCHMAN FLX™continued market expansion of Left Atrial Appendage Closure (LAAC) procedures with our WATCHMAN™ FLX LAAC Device, as well as performance of our percutaneous coronary intervention guidance (PCIG)and subcutaneous implantable cardiac defibrillator (S-ICD) franchises. Organic net sales growth was also driven by our diagnostics franchise, andled by our drug-eluting
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stent (DES) systems due to the recovery of procedure volumes compared to the prior year, particularlyLUX-Dx™ Insertable Cardiac Monitor (ICM) system, as well as our wearable ambulatory electrocardiograph portfolio. In addition, sales growth in the first half, when the COVID-19 pandemic had a significant negative impact onsix months of 2022 was driven by our net sales. In addition, growth was positively impactedstructural heart valve franchise led by reserves recorded in the third quarter of 2020 primarily related to our conversion to a consignment inventory model for our LAAC franchise with the launch of our WATCHMAN FLX™ Device in the U.S. These increases were partially offset by the discontinuation of our LOTUS Edge™ACURATE neo2™ Aortic Valve System in the fourth quarter of 2020, general price declines associated with our DES systems and the unfavorable impact of China tender pricing on both DES systems and balloon catheter net sales following a reduction in prices in the first quarter of 2021.Systems.

Peripheral Interventions

Our Peripheral Interventions business develops and manufactures products to diagnose and treat peripheral arterial and venous diseases, as well as products to diagnose, treat and ease various forms of cancer. Our net sales of Peripheral Interventions products were $452$478 million for the thirdsecond quarter of 2021 and $1.358 billion$944 million for the first ninesix months of 2021,2022, representing 15 percent of our consolidated net sales in both the third quarter and first nine months of 2021.periods. Our Peripheral Interventions net sales increased $36$6 million, or 8.81.2 percent, in the thirdsecond quarter of 2021 and increased $210$38 million, or 18.34.2 percent, in the first ninesix months of 2021,2022, compared to the prior year periods. In the thirdsecond quarter of 2021,2022, this increase included operational net sales growth of 8.15.7 percent and a positivenegative impact of 70450 basis points from foreign currency fluctuations, compared to the prior year period. In the first ninesix months of 2021,2022, this increase included operational net sales growth of 16.17.8 percent and a positivenegative impact of 220360 basis points from foreign currency fluctuations, compared to the prior year period.

Operational net sales growth was primarily driven by the Interventional Oncologyour drug eluting franchise includingled by our RangerTM Drug-Coated Balloon and EluviaTM Drug-Eluting Stent System within our arterial portfolio as well as our interventional oncology franchise led by our TheraSphere™ Y-90 Radioactive Glass Microspheres, which received U.S. Food and Drug Administration approval in the first quarter of 2021 after 20 years as a humanitarian device exemption (HDE). In addition, growth was driven by our drug-eluting portfolio, including the Eluvia™ Drug-Eluting Stent and Ranger™ Drug-Coated Balloon due to the recovery of procedure volumes compared to the prior year, particularly in the first half, when the COVID-19 pandemic had a significant negative impact on our net sales, as well as continued worldwide commercial execution and adoption in recently approved countries. In the first quarter of 2021, we received approval from Japan’s Ministry of Health, Labor and Welfare (MHLW) for our Ranger Drug-Coated Balloon and initiated a full launch.Microspheres.

Specialty Pharmaceuticals

On March 1, 2021, we completed the divestiture of the Specialty Pharmaceuticals business for a purchase price of approximately $800 million. Our consolidated net sales include Specialty Pharmaceuticals up to the date of the closing of the transaction.

Emerging Markets

As part of our strategic imperative to drive global expansion, we are seeking to grow net sales and market share by expanding our global presence, including in Emerging Markets. We define Emerging Markets as the 20 countries that we believe have strong growth potential based on their economic conditions, healthcare sectors and our global capabilities. Periodically, we assess our list of Emerging Markets countries, and effective January 1, 2021, modified our list to includewhich currently includes the following countries: Brazil, Chile, China, Colombia, Czech Republic, India, Indonesia, Malaysia, Mexico, Philippines, Poland, Russia, Saudi Arabia, Slovakia, South Africa, South Korea, Taiwan, Thailand, Turkey and Vietnam. We have revised prior period amounts to conform to the current year's presentation which had an immaterial impact on previously reported Emerging Markets net sales. Our Emerging Markets net sales represented 1213 percent of our consolidated net sales in both the thirdsecond quarter and first ninesix months of 2021, 11 percent in the third quarter of 2020,2022, and 12 percent in the second quarter and first ninesix months of 2020.2021. In the thirdsecond quarter of 2021,2022, our Emerging Markets net sales grew 21.918.9 percent on a reported basis, which included operational net sales growth of 17.826.0 percent and a positivenegative impact of 410710 basis points from foreign currency fluctuations, compared to the prior year period. In the first ninesix months of 2021,2022, our Emerging Markets net sales grew 23.820.8 percent on a reported basis, which included operational net sales growth of 18.927.3 percent and a positivenegative impact of 490650 basis points from foreign currency fluctuations, compared to the prior year period. The growthincrease in the thirdsecond quarter and first nine months of 20212022 compared to the prior year periodsperiod was driven primarily by our net salesgrowth in China, which have largely recovered from the impact of the COVID-19 pandemicIndia and Brazil as we continue to focus on procedural volumes.

globalization
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of our products. We experienced sequentially lower growth in China in the second quarter of 2022 due to decreased procedural volumes related to the recent increase of COVID-19 cases and associated public health measures implemented. The increase in the first six months of 2022 compared to the prior year period was driven primarily by growth in China, India and Brazil.

Gross Profit

Our Gross profit was $2.032$2.233 billion for the thirdsecond quarter of 2022, $2.132 billion for the second quarter of 2021, $1.790$4.304 billion for the third quarter of 2020, $6.022 billion for the first ninesix months of 20212022 and $4.740$3.990 billion for the first ninesix months of 2020.2021. As a percentage of net sales, our Gross profit increaseddecreased to 68.8 percent in the second quarter of 2022, as compared to 69.3 percent in the thirdsecond quarter of 2021 as comparedand increased to 67.3 percent in the third quarter of 2020 and 68.768.6 percent in the first ninesix months of 2021,2022, as compared to 65.868.4 percent in the first ninesix months of 2020.2021. The following is a reconciliation of our gross profit margin and a description of the drivers of the changes from period to period:
Percentage of Net Sales
Three MonthsNine Months
Gross profit margin - period ended September 30, 202067.3%65.8%
Abnormal production variances0.51.4
Sales pricing, volume and mix0.41.3
Inventory charges0.90.4
All other, including other expenses0.2(0.1)
Gross profit margin - period ended September 30, 202169.3%68.7%
Percentage of Net Sales
Three MonthsSix Months
Gross profit margin - period ended June 30, 202169.3%68.4%
Sales pricing, volume and mix(0.3)0.1
Net impact of foreign currency fluctuations1.11.0
All other, including other period expenses(1.3)(0.8)
Gross profit margin - period ended June 30, 202268.8%68.6%

The primary factors contributing to the increasedecrease in our gross profit margin in the thirdsecond quarter and first nine months of 2021,2022, as compared to the same periodsperiod in 2020, were higher sales volumes and favorable product mix associated with the resumption of procedures using higher-margin products, as well as the prior year, impactwere the impacts of abnormal production variances attributable to manufacturing plant shut-downs and excess and obsolete inventory charges due to lower forecasted demand for certain of our products driven by the COVID-19 pandemic in the prior year. These improvements were partially offset by price declines related primarily to sales of our coronary drug-eluting stent systems and foreign currency fluctuations. In addition, inflation has put pressure on our gross profit margin, particularly with increases in costs of certain raw materials, direct labor and freight.freight, as well as inefficiencies in our manufacturing plants due to constraints in material availability, which were partially offset by the favorable impact of foreign currency fluctuations and the realization of standard cost improvements. As expected, these macro-economic factors have negatively impacted our gross profit margin, and we expect continued negative impact throughout 2022 while these factors persist. Despite the challenging macro-economic environment, we experienced an overall increase in our gross profit margin in first six months of 2022, as compared to the same period in the prior year, due to increased sales of higher-margin products and the favorable impact of foreign currency fluctuations, which offset the macro-economic factors that became more pronounced in the second quarter of 2022.

Operating Expenses

The following table provides a summary of certain of our operating expenses:
Three Months Ended September 30,Nine Months Ended September 30, Three Months Ended June 30,Six Months Ended June 30,
2021202020212020 2022202120222021
(in millions)(in millions)$% of Net Sales$% of Net Sales$% of Net Sales$% of Net Sales(in millions)$% of Net Sales$% of Net Sales$% of Net Sales$% of Net Sales
Selling, general and administrative (SG&A) expenses$1,066 36.4 %$984 37.0 %$3,206 36.6 %$2,760 38.3 %
Research and development (R&D) expenses310 10.6 %315 11.9 %884 10.1 %857 11.9 %
Selling, general and administrative expensesSelling, general and administrative expenses$1,165 35.9 %$1,121 36.4 %$2,225 35.5 %$2,139 36.7 %
Research and development expensesResearch and development expenses335 10.3 %298 9.7 %654 10.4 %574 9.9 %
Royalty expenseRoyalty expense14 0.5 %12 0.4 %38 0.4 %32 0.4 %Royalty expense11 0.3 %12 0.4 %23 0.4 %24 0.4 %

Selling, general and administrative expenses (SG&A ExpensesExpenses)

In the thirdsecond quarter of 2021, our2022, SG&A expenses increased $83$45 million, or 84 percent, as compared to the third quarter of 2020prior year period and were 6050 basis points lower as a percentage of net sales. In the first ninesix months of 2021, our2022, SG&A expenses increased $445$86 million, or 164 percent, as compared to the first nine months of 2020prior year period and were 170120 basis points lower as a percentage of net sales. The increaseincreases in SG&A expenses for the third quarter and first nine months of 2021, as compared to the same period in the prior year, waswere primarily due to higher selling costs driven by higher global net sales and the targeted lifting of spending controls implemented during the first nine months of 2020 in response to the escalating COVID-19 pandemic. In addition, SG&A expenses in the first nine months of 2021 were further impacted by higher restructuring-related spend and acquisition-related charges.sales.

Research and development expenses (R&D ExpensesExpenses)

We remain committed to advancing medical technologies and investing in meaningful R&D projects across our businesses. In the thirdsecond quarter of 2021, our2022, R&D expenses decreased $5increased $36 million, or 212 percent, as compared to the third quarter of 2020prior year period and were 13060 basis points lowerhigher as a percentage of net sales due to higher one-time charges in the prior year.sales. In the first ninesix months of 2021,2022, our R&D expenses increased $27$79 million, or 3 percent, as compared to the first nine months of 2020, and were
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18014 percent, as compared to the prior year period, and were 60 basis points lowerhigher as a percentage of net sales. R&D expenses increased in both the second quarter and first ninesix months of 2021, as compared to the same period in the prior year,2022 as a result of investments across our businesses in order to maintain a pipeline of new products that we believe will contribute to profitable sales growth.

Royalty Expense

In the third quarter of 2021, our Royalty expense increased $2 million, or 17 percent as compared to the third quarter of 2020 and remained relatively flat as a percentage of net sales. In the first nine months of 2021, our Royalty expense increased $6 million, or 19 percent, as compared to the first nine months of 2020, and remained flat as a percentage of net sales, primarily due to global net sales growth in the third quarter and first nine months of 2021 as compared to the third quarter and first nine months of 2020.

Other Operating Expenses

The following table provides a summary of certain of our other operating expenses, which are excluded by management for purposes of evaluating operating performance, referperformance. Refer to Additional Information for a further description of certain operating expenses:
Three Months Ended
September 30,
Nine Months Ended
September 30,
Three Months Ended
June 30,
Six Months Ended
June 30,
(in millions)(in millions)2021202020212020(in millions)2022202120222021
Amortization expenseAmortization expense$184 $197 $549 $595 Amortization expense$204 $180 $402 $365 
Intangible asset impairment chargesIntangible asset impairment charges128 219 173 452 Intangible asset impairment charges45 45 
Contingent consideration net expense (benefit)Contingent consideration net expense (benefit)(26)(117)(102)Contingent consideration net expense (benefit)36 (85)48 (91)
Restructuring charges (credits)Restructuring charges (credits)18 16 Restructuring charges (credits)11 14 
Litigation-related net charges (credits)Litigation-related net charges (credits)— 260 302 260 Litigation-related net charges (credits)42 298 42 302 
Gain on disposal of businesses and assetsGain on disposal of businesses and assets(40)— (48)— Gain on disposal of businesses and assets— (2)— (9)

Amortization Expense

In the thirdsecond quarter of 2021, our2022, Amortization expense decreased $13increased $24 million, or 713 percent, as compared to third quarter of 2020.the prior year period. In the first ninesix months of 2021, our2022, Amortization expense decreased $47increased $37 million, or 810 percent, as compared to first ninesix months of 2020.2021. The decreaseincrease in Amortization expense in both the thirdsecond quarter and first ninesix months of 2021, as compared to the same period in the prior year,2022 was driven by the divestiture of the Specialty Pharmaceuticals business partially offset by the addition of amortizable intangible assets associated with our recent acquisitions.

Intangible Asset Impairment Charges

We recorded Intangible asset impairment charges of $128$7 million in the thirdsecond quarter and first six months of 2021, $2192022, and $45 million in the thirdsecond quarter of 2020, $173 million in theand first ninesix months of 2021 and $452 million in the first nine months of 2020.2021. The impairment charges recorded in the third quarter of 2021 were primarily associated with amortizable technology-related intangible assets that were initially established following our acquisition of VENITI, Inc.,attributable to incremental time and in the first nine months of 2021 also included the partial impairment of one of our acquired IPR&D assets. In the third quarter of 2020, impairment charges were primarily associated with IPR&D acquired with Apama Medical, Inc. and in the first nine months of 2020 also included charges primarily associated with amortizable technology-related intangible assets that were initially established following our acquisition of nVision Medical Corporation. Each of these charges were recorded as a result of management’s decision to change commercial launch plans or discontinue certain commercial or R&D programs based on cost to complete or remediate, time to market, overall economic viability or, specific to nVision, our understanding of the clinical evidence necessary to commercialize the technology.an acquired in-process research and development (IPR&D) project. Refer to Note C – Goodwill and Other Intangible Assets to our unaudited consolidated financial statements contained in Item 1 of this Quarterly Report on Form 10-Q and Critical Accounting Estimates in Item 7 of our most recent Annual Report on Form 10-K for additional details and a discussion of key assumptions used in our goodwill and intangible asset impairment testing and future events that could have a negative impact on the recoverability of our goodwill and intangible assets.
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Contingent Consideration Net Expense (Benefit)

To recognize changes in the fair value of our contingent consideration liability, we recorded net benefitscharges of $26$36 million and $117$48 million in the thirdsecond quarter and first ninesix months of 2022, respectively, and net benefits of $85 million and $91 million in the in the second quarter and first six months of 2021, respectively, arespectively. The net expense of $6 million in the third quarter of 2020 and a net benefit of $102 millioncharges recorded in the first ninesix months of 2020.2022 related to an increase in expected payments for achievement of commercialization-based milestones and revenue-based payments as a result of over-performance. In addition, we made payments of $314 million associated with prior acquisitions during the first six months of 2022, following the achievement of revenue and/or regulatory milestones. The net benefits recorded in the first ninesix months of 2021 and 2020 related to a reduction in the contingent consideration liability for certain prior acquisitions for which we reduced the probability of achievement of associated revenue and/or regulatory milestones upon which payment is conditioned, or, in the case of nVision, for milestones that would not be achieved due to management's discontinuation of the R&D program. In addition, we made payments of $14 million associated with prior acquisitions during the first ninesix months of 2021, following the achievement of a revenue-based milestone. Refer to Note B – Acquisitions, Divestitures and Strategic Investments to our unaudited consolidated financial statements contained in Item 1 of this Quarterly Report on Form 10-Q for additional details related to our contingent consideration arrangements.

Restructuring Charges (Credits)

In November 2018, our Board of Directors approved, and we committed to, a new global restructuring program (the 2019 Restructuring Plan). The 2019 Restructuring Plan, for whichIn addition, on February 22, 2022, our Board of Directors approved an extension and expansion in February 2021, isincreased cost estimates to complete
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additional activities identified under the program, which are expected to result in total pre-tax charges of approximately $450 million to $500 million, and approximately $375 million to $475 million and approximately $340 million to $440$425 million of these charges are expected to result in cash outlays. We expect the majority of activity associated with our 2019 Restructuring Plan including the extension, to be substantially complete by the end of 2022. A substantial portion of the savings are being reinvested in strategic growth initiatives. Pursuant to this program, restructuring charges were $9$11 million in the thirdsecond quarter of 2021,2022, $3 million in the thirdsecond quarter of 2020, $152021, $14 million in the first ninesix months of 20212022 and $16$6 million in the first ninesix months of 2020.2021. Restructuring-related charges were $34$24 million in the thirdsecond quarter of 2022, $35 million in the second quarter of 2021, $20 million in the third quarter of 2020, $98$49 million in the first ninesix months of 20212022 and $61$64 million in the first ninesix months of 20202021, and were recorded primarily in Cost of products sold and SG&A expenses.

In addition, on November 17, 2020, we announced a global, voluntary recall of all unused inventory of our LOTUS Edge™EdgeTM Aortic Valve System and our decision to retire the entire LOTUS™LOTUSTM Valve platform. We recorded immaterial restructuring and restructuring-related charges associated with the product discontinuation in the third quarter of 2021 and recorded $2 million of restructuring charges and $17$16 million of restructuring-related charges associated with the product discontinuation in the first ninesix months of 2021. The product discontinuationrestructuring activities were completed in 2021 and resulted in total pre-tax restructuring and restructuring-related net charges of approximately $80 million. We substantially completed the restructuring activities in the first quarter of 2021.

Refer to Note H – Restructuring-related Activities to our audited financial statements contained in Item 8 of our most recent Annual Report on Form 10-K for additional information.

Litigation-related net charges (credits)

We did not record anyrecorded litigation-related net charges of $42 million during the thirdsecond quarter and first six months of 20212022. We recorded litigation-related net charges of $298 million during the second quarter and recorded $302 million during the first ninesix months of 2021, primarily related primarily to transvaginal surgical mesh products. During the first nine months of 2021 weWe increased the accrual associated with this matter to account for increased, post-COVID-19 pandemic settlement and litigation activity related to the remaining cases and claims the Company faces, our revision of the per-case settlement amount for these cases is based on recent settlement and litigation activity and changes to our expectations regarding the rate of incoming cases and claims. We recorded litigation-related net charges of $260 million during the third quarter and first nine months of 2020, primarily related to transvaginal mesh products, inclusive of a reserve related to claims made by a coalition of state attorneys general. We record certain legal and product liability charges, credits and costs of defense, which we consider to be unusual or infrequent and significant as Litigation-related net charges (credits) inwithin our accompanying unaudited consolidated financial statements. All other legal and product liability charges, credits and costs are recorded within SG&A expenses.

We continue to assess certain litigation and claims to determine the amounts, if any, that management believes will be paid as a result of such claims and litigation, and therefore, additional losses may be accrued and paid in the future, which could materially adversely impact our operating results, cash flows and/or our ability to comply with the financial covenant required by our credit arrangements. Refer to Note H – Commitments and Contingencies to our unaudited consolidated financial statements contained in Item 1 of this Quarterly Report on Form 10-Q for discussion of our material legal proceedings.

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Interest Expense
The following table provides a summary of our Interest expense and average borrowing rate:
Three Months Ended September 30,Nine Months Ended September 30,Three Months Ended June 30,Six Months Ended June 30,
20212020202120202022202120222021
Interest expense (in millions)
Interest expense (in millions)
$(86)$(86)$(254)$(265)
Interest expense (in millions)
$(64)$(86)$(343)$(168)
Average borrowing rateAverage borrowing rate3.6 %3.4 %3.6 %3.4 %Average borrowing rate2.7 %3.6 %7.2 %3.6 %

Interest expense and our average borrowing rate remained relatively flatdecreased in the thirdsecond quarter and first nine months of 2021, as2022 compared to the same periodsprior year period, due to the issuance of euro-denominated bonds in the first quarter of 2022, which carry lower interest rates than our prior year. Duringperiod debt portfolio. Interest expense and our average borrowing rate increased in the first ninesix months of 2020, we took proactive steps2022 compared to manage the potential impactprior year period due to $194 million of charges associated with the COVID-19 pandemic onearly extinguishment of $3.275 billion of certain of our short-term liquidity and refinanced existing term loans and outstanding commercial paper with proceeds from new term loans and our 2018 Revolving Credit Facility. We refinanced this short-term, variable-rate debt in May 2020 with our issuances of $500 million 1.900% senior notes, due June 2025including payment of tender premiums and $1.200 billion 2.650% senior notes due June 2030. During the third quarteracceleration of 2020, we prepaid the remaining $250 million outstanding under our February 2021 Term Loan and terminated the facility.unamortized debt issuance costs. Refer to Liquidity and Capital Resources and Note E – Contractual Obligations and Commitments to our unaudited consolidated financial statements contained in Item 1 of this Quarterly Report on Form 10-Q for information regarding our debt obligations.

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Other, net

The following are the components of Other, net:
Three Months Ended September 30,Nine Months Ended September 30, Three Months Ended June 30,Six Months Ended June 30,
(in millions)(in millions)2021202020212020(in millions)2022202120222021
Interest incomeInterest income$$$$Interest income$$$$
Net foreign currency gain (loss)Net foreign currency gain (loss)(8)(1)(17)(13)Net foreign currency gain (loss)(7)(7)(9)
Net gains (losses) on investmentsNet gains (losses) on investments186 48 208 14 Net gains (losses) on investments(16)(14)(36)22 
Other income (expense), netOther income (expense), net16 (3)Other income (expense), net(0)(7)(7)(5)
$181 $64 $192 $9  $(14)$(26)$(46)$11 

In the third quarter and first nine months of 2021, in connection with the acquisitionsacquisition of Farapulse and Preventice in the first quarter of 2021, we remeasured the fair value of our previously-held interests in the acquired companies,equity interest, which resulted in a $222 million and $195 million gain respectively, recognized within Other, net. In addition, in the thirdfirst six months of 2021. In the second quarter and first ninesix months of 2021, we also recorded losses of $24$8 million and $178$154 million, respectively, on our investment in Pulmonx Corporation presented in Other, net associated with the partial disposition of our ownership and remeasurement of our remaining investment during the period to fair value based on observable market prices, as well as the disposition of our remaining ownership.prices. The Preventice and Farapulse gains aregain is included within Acquisition/divestiture-related net charges (credits) and the Pulmonx loss is included in Investment portfolio net losses (gains)presented in the reconciliation of our results of operations prepared in accordance with U.S. GAAP to those adjusted results considered by management. Refer to Financial Summary for the reconciliation and Additional Information for a discussion of management's use of non-GAAP financial measures.


Tax RatesRate

Our effective tax rate from continuing operations is presented below:
Three Months Ended September 30,Nine Months Ended September 30,
2021202020212020
Effective tax rate from continuing operations13.2 %31.7 %1.1 %24.3 %
Three Months Ended June 30,Six Months Ended June 30,
2022202120222021
Effective tax rate from continuing operations24.7 %(24.9)%26.1 %(11.2)%

The changechanges in our reported tax rates for the thirdsecond quarter and first ninesix months of 2021,2022, as compared to the same periods in 2020, relates2021, relate primarily to the impact of certain receipts and charges that are taxed at different rates than our effective tax rate. These include acquisition/divestiture-related charges and receipts, charges and charges includereceipts on investment portfolio net losses (gains), litigation-related net charges (credits), intangible asset impairment charges, acquisition/
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divestiture-related net charges, as well as certain discrete tax items primarily related to an IRS audit settlementchanges in the third quarter of 2020.

Economic stimulus legislation has been enactedtax laws, unrecognized tax benefits, changes in many countries in response to the COVID-19 pandemic. In the U.S., the CARES Act, enacted on March 27, 2020, provided an estimated $2.2 trillion in COVID-19 pandemic-related relief,valuation allowance and included tax relief and government loans, subsidies and other relief for entities in affected industries. While we have not applied for government loans, we have taken advantage of the benefits offered in multiple jurisdictions, including the U.S. provision allowing taxpayers to defer payment of the employer portion of certain payroll taxes incurred in 2020. This allowed us to preserve cash generated from operations to service our debt obligations and other near-term commitments and is expected to be paid in full by the end of 2022 as permitted by the legislation.foreign return-to-provision adjustments.

Critical Accounting Policies and Estimates
Our financial results are affected by the selection and application of accounting policies and methods. In the second quarter and first ninesix months of 2021,2022, there were no material changes to the application of critical accounting policies previously disclosed in our most recent Annual Report on Form 10-K.


Liquidity and Capital Resources

Due to the uncertainty of the impact of the COVID-19 pandemic on our business, we took proactive steps in 2020 to reduce costs and ensure we are in a strong position to support customers and patients as healthcare systems recover and elective and semi-emergent procedures resume. These actions included taking steps to manage outstanding borrowings and increase available liquidity, and preemptively amending our financial covenant requirement for our outstanding credit arrangements.

Based on our current business plan, we believe our existing balance of Cash and cash equivalents, future cash generated from operations, access to capital markets and existing credit facilities will be sufficient to fund our operations, invest in our infrastructure, pay our legal-related liabilities, pay taxes due, service and repay our existing debt and fund possible acquisitions for at least the next 12 months. We expect to fundmonths and for the previously announced definitive agreements to acquire Devoro Medical, Inc. and Baylis Medical Company, Inc. using cash on hand on the closing date of the transactions, expected in the fourth quarter of 2021 and the first quarter of 2022, respectively. Please refer to Contractual Obligations and Commitments below for additional details on our future payment obligations and commitments.foreseeable future.

As of SeptemberJune 30, 2021,2022, we had $1.947 billion$276 million of unrestricted Cash and cash equivalents on hand, comprised of $1.537 billion$36 million invested in money market funds and time deposits and $410$240 million in interest bearing and non-interest-bearing bank accounts. We invest excess cash on hand in short-term financial instruments that earn at market interest rates while mitigating principal risk through instrument and counterparty diversification, as well as what we believe to be prudent instrument selection. We limit our direct exposure to securities in any one industry or issuer.

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In 2021, we entered into a new $2.750 billion revolving credit facility (2021 Revolving Credit Facility) with a global syndicate of commercial banks and terminated our previous facility (2018 Revolving Credit Facility). The 2021 Revolving Credit Facility will mature on May 10, 2026, with one-year extension options, subject to certain conditions. This facility provides backing for our commercial paper program, and outstanding commercial paper directly reduces borrowing capacity under the 2021 Revolving Credit Facility. As of SeptemberJune 30, 2021,2022, we had no$155 million of commercial paper debt outstanding, resulting in an additional $2.750$2.595 billion of available liquidity.liquidity under the 2021 Revolving Credit Facility.

For additional details related to our debt obligations, including our financial covenant requirement, refer to Note E – Contractual Obligations and Commitments to our unaudited consolidated financial statements contained in Item 1 of this Quarterly Report on Form 10-Q.

The following provides a summary and description of our net cash inflows (outflows):
Nine Months Ended September 30,Six Months Ended June 30,
(in millions)(in millions)20212020(in millions)20222021
Cash provided by (used for) operating activitiesCash provided by (used for) operating activities$1,392 $835 Cash provided by (used for) operating activities$249 $927 
Cash provided by (used for) investing activitiesCash provided by (used for) investing activities(1,136)(264)Cash provided by (used for) investing activities(1,603)71 
Cash provided by (used for) financing activitiesCash provided by (used for) financing activities(87)1,112 Cash provided by (used for) financing activities(350)(93)

Operating Activities

In the first ninesix months of 2021,2022, cash provided by operating activities increased $557decreased $678 million as compared to the first nine months of 2020,prior year period primarily due to changes in working capital partially offset by comparatively higher net sales and operating income compared to the same period in the prior year.
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income.

Investing Activities

In the first ninesix months of 2022, cash used for investing activities included a net cash payment of $1.471 billion for the acquisition of Baylis Medical. In the first six months of 2021, cash provided by investing activities included proceeds of $801 million from the divestiture of the Specialty Pharmaceuticals business and $329$92 million of proceeds from the sale of(payments for) investments and dispositionacquisitions of certain assets,technologies, partially offset by a net cash payment of $2.014 billion$706 million for the acquisitionsacquisition of Preventice, Lumenis and Farapulse.Preventice. For more information, refer to Note B – Acquisitions, Divestitures and Strategic Investments to our unaudited consolidated financial statements contained in Item 1 of this Quarterly Report on Form 10-Q. In addition, we made purchases of property, plant and equipment and internal use software of $288$226 million in the first ninesix months of 20212022 and $217$181 million in the first ninesix months of 2020.2021.

Financing Activities

In the first ninesix months of 2022, we completed a public offering (the Offering) of €3.000 billion in aggregate principal amount of euro-dominated senior notes. The Offering resulted in cash proceeds of $3.270 billion, net of investor discounts and issuance costs. We used the net proceeds from the Offering to fund the tender offer and early redemption of combined aggregate principal amount of $3.275 billion of certain of our outstanding senior notes, as well as to pay accrued interest, tender premiums, fees and expenses. Cash used for financing activities in the first six months of 2022 also included payments on short-term borrowings of $250 million, payment of contingent consideration previously established in purchase accounting of $283 million and an increase (decrease) in commercial paper of $154 million. For more information, refer to Note E – Contractual Obligations and Commitments to our unaudited consolidated financial statements contained in Item 1 of this Quarterly Report on Form 10-Q. In the first six months of 2022 and 2021, cash used for financing activities primarilyalso included cash payments associated with the settlement of employee equity awards dividends paid to shareholders of our mandatory convertible preferred stock and payments for royalty rights associated with the Zytiga™ Drug. On May 10, 2021 we entered into a new $2.750 billion revolving credit facility (2021 Revolving Credit Facility) with a global syndicate of commercial banks and terminated our previous facility (2018 Revolving Credit Facility). The 2021 Revolving Credit Facility will mature on May 10, 2026, with one-year extension options, subject to certain conditions. We have not made any borrowings against the 2021 Revolving Credit Facility.

In the first nine months of 2020, we took proactive steps to manage the potential impact of the emerging COVID-19 pandemic on our short-term liquidity and refinanced our existing term loans and outstanding commercial paper with proceeds from new term loans, borrowings against our 2018 Revolving Credit Facility, a senior notes offering and public equity offerings of preferred and common stock.

Please refer to Note F – Contractual Obligations and Commitments to our audited financial statements contained in Item 8 of our most recent Annual Report on Form 10-K for additional information regarding financing activities for the year ended December 31, 2020, including the full repayment of amounts borrowed against our credit facility and partial repayment of amounts borrowed under term loans in the first nine months of 2020.

Financial Covenant

As of and through SeptemberJune 30, 2021,2022, we were in compliance with the financial covenant required by the credit facilities.2021 Revolving Credit Facility described below.

The 2021 Revolving Credit Facility includes the following financial covenant requirement for all of our credit arrangements (i)that we maintain the maximum permitted leverage ratio of 4.00 times for the third quarter of 2021, with a step-down to 3.75 times for the fourth quarter of 2021 and through the remaining term. The agreement provides for higher leverage ratios, at our election, for the period following a qualified acquisition at our election, for which consideration exceeds $1.000 billion. In the event of such an acquisition, for the four succeeding quarters immediately following, including the quarter in which the
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acquisition occurs, the maximum permitted leverage ratio is 4.75 times. The maximum permitted ratio steps down for the fifth, sixth and seventh succeeding quarters to 4.50 times, 4.25 times and 4.00 times, respectively. Thereafter, a maximum leverage ratio of 3.75 times is required through the remaining term of the 2021 Revolving Credit Facility. We have not elected to increase the maximum permitted leverage ratio for the recently completed acquisition of Lumenisqualified acquisitions due to the funding of the acquisition using cash on hand. We believe that we have the ability to comply with the financial covenant for the next 12 months.

The financial covenant requirement provides for an exclusion from the calculation of consolidated EBITDA, as defined by the agreement, through maturity, of any non-cash charges and up to $500 million in restructuring charges and restructuring-related expenses related to our current or future restructuring plans. As of SeptemberJune 30, 2021,2022, we had $428$311 million of the restructuring charge exclusion remaining. In addition, any cash litigation payments (net of any cash litigation receipts), as defined by the agreements,agreement, are excluded from the calculation of consolidated EBITDA, as defined by the agreements,agreement, provided that the sum of any excluded net cash litigation payments do not exceed $1.455 billion in the aggregate. As of SeptemberJune 30, 2021,2022, we had $1.243$1.080 billion of the litigation exclusion remaining.
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Contractual Obligations and Commitments

Certain of our acquisitions involve the payment of contingent consideration. SeeRefer to Note B – Acquisitions, Divestitures and Strategic Investments to our unaudited consolidated financial statements contained in Item 1 of this Quarterly Report on Form 10-Q for further details regarding the estimated potential amount of future contingent consideration we could be required to pay associated with our acquisitions. There have been no other material changes to our contractual obligations and commitments as reported in our most recent Annual Report filed on Form 10-K.of June 30, 2022.

Equity

On May 27, 2020, we completed an offering of 10,062,500 shares of 5.50% Mandatory Convertible Preferred Stock, Series A (MCPS) at a price to the public and liquidation preference of $100 per share. The net proceeds from the MCPS offering were approximately $975 million after deducting underwriting discounts and commissions and offering expenses. On May 27, 2020, we also completed an offering of 29,382,500 shares of common stock at a public offering price of $34.25 per share. The net proceeds from the common stock offering were approximately $975 million after deducting underwriting discounts and commissions and offering expenses.

We received $102$58 million in the first ninesix months of 20212022 and $107$38 million in the first ninesix months of 20202021 in proceeds from stock issuances related to our stock option and employee stock purchase plans. Proceeds from the exercise of employee stock options and employee stock purchases vary from period to period based upon, among other factors, fluctuations in the trading price of our common stock and in the exercise and stock purchase patterns of our employees.

We did not repurchase any shares of our common stock in the second quarter or first ninesix months of 20212022 or 2020.2021. On December 14, 2020, our Board of Directors approved a new stock repurchase program authorizing the repurchase of up to $1.000 billion of our common stock. As of SeptemberJune 30, 2021,2022, we had the full amount remaining available under the authorization.

Legal Matters

For a discussion of our material legal proceedings seerefer to Note H – Commitments and Contingencies to our unaudited consolidated financial statements contained in Item 1 of this Quarterly Report on Form 10-Q and Note K – Commitments and Contingencies to our audited financial statements contained in Item 8 of our most recent Annual Report on Form 10-K.
Recent Accounting Pronouncements
Information regarding new accounting pronouncements implemented since December 31, 2020 is included in Note A – Basis of Presentation2021 and information regarding new accounting pronouncements to be implemented is included in Note N – New Accounting Pronouncements to our unaudited consolidated financial statements contained in Item 1 of this Quarterly Report on Form 10-Q.

Additional Information

Cybersecurity

We have established controls and procedures to escalate enterprise level issues, including cybersecurity matters, to the appropriate management levels within our organization and our Board of Directors, or members or committees thereof, as appropriate. Under our framework, cybersecurity issues are analyzed by subject matter experts and a crisis committee for potential financial, operational, and reputational risks, based on, among other factors, the nature of the matter and breadth of impact. Matters determined to present potential material impacts to the Company’s financial results, operations, and/or reputation are immediately reported by management to the Board of Directors, or individual members or committees thereof, as appropriate, in accordance with our escalation framework. In addition, we have established procedures to ensure that management responsible for overseeing the effectiveness of disclosure controls is informed in a timely manner of known cybersecurity risks and incidents that may materially impact our operations and that timely public disclosure is made or updated, as appropriate. 
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The conflict between Russia and Ukraine raises cybersecurity risks on a global basis. While there is significant uncertainty around implications of cybersecurity attacks resulting from the conflict, we have taken steps to better understand our readiness, including the resilience of our critical business functions, with the goal of reducing the impact if such an event were to occur.

Stock Trading Policy

Our directors and executive officers are subject to our Stock Trading Policy, which is designed to facilitate compliance with insider trading laws and governs transactions in our common stock and related derivative securities. Our policy designates certain regular periods, dictated by release of financial results, in which trading is restricted for individuals in information-sensitive positions, including directors and executive officers. In addition, additional periods of trading restriction may be imposed as determined by the President and Chief Executive Officer, General Counsel, or Chief Financial Officer in light of material pending developments. Further, during permitted windows, individuals in information-sensitive positions are required to seek pre-clearance for trades from the General Counsel, who assesses whether there are any important pending developments, including cybersecurity matters, which need to be made public before the individual may participate in the market.

Periodically, certain of our executive officers adopt written stock trading plans in accordance with Rule 10b5-1 under the Exchange Act and our own Stock Trading Policy. A Rule 10b5-1 Trading Plan is a written document that pre-establishes the amount, prices and dates (or formulas for determining the amounts, prices and dates) of future purchases or sales of our stock, including shares issued upon exercise of stock options or vesting of deferred stock units. These plans are entered into at a time when the person is not in possession of material non-public information about the Company. We disclose details regarding individual Rule 10b5-1 Trading Plans on the Investor Relations section of our website.

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Use of Non-GAAP Financial Measures

To supplement our unaudited consolidated financial statements presented on a GAAP basis, we disclose certain non-GAAP financial measures, including adjusted net income (loss), adjusted net income (loss) available to common stockholders and adjusted net income (loss) per share (EPS) that exclude certain amounts;charges (credits); operational net sales, which exclude the impact of foreign currency fluctuations; and organic net sales, which exclude the impact of foreign currency fluctuations as well as the impact of certain acquisitions and divestitures with less than a full period of comparable net sales. These non-GAAP financial measures are not in accordance with generally accepted accounting principles in the United States and should not be considered in isolation from or as a replacement for the most directly comparable GAAP financial measures. Further, other companies may calculate these non-GAAP financial measures differently than we do, which may limit the usefulness of those measures for comparative purposes.

To calculate adjusted net income (loss), adjusted net income (loss) available to common stockholders and adjusted net income (loss) per share we exclude certain charges (credits) from GAAP, which include amortization expense, goodwill and intangible asset impairment charges, acquisition/divestiture-related net income (loss)charges (credits), investment portfolio gains and GAAPlosses, restructuring and restructuring-related net income (loss) available to common stockholders.charges (credits); and certain litigation-related net charges (credits), EU MDR implementation costs, debt extinguishment charges, deferred tax expenses (benefits) and discrete tax items. Amounts are presented after-tax usingat our effective tax rate, unless the amount is a significant unusual or infrequently occurring item in accordance with Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) sectionTopic 740-270-30, "General Methodology and Use of Estimated Annual Effective Tax Rate." Please refer to Part II, Item 7. Management's Discussion and Analysis of Financial Condition and Results of Operations in our most recent Annual Report filed on Form 10-K filed with the Securities and Exchange Commission (SEC) for an explanation of each of these adjustments and the reasons for excluding each item.

The GAAP financial measures most directly comparable to adjusted net income (loss), adjusted net income (loss) available to common stockholders and adjusted net income (loss) per share are GAAP net income (loss), GAAP net income (loss) available to common stockholders and GAAP net income (loss) per common share - assuming dilution, respectively.

To calculate operational net sales growth rates, which exclude the impact of foreign currency fluctuations, we convert actual net sales from local currency to U.S. dollars using constant foreign currency exchange rates in the current and prior periods. To calculate organic net sales growth rates, we also remove the impact of acquisitions and divestitures with less than a full period of comparable net sales. The GAAP financial measure most directly comparable to operational net sales and organic net sales is net sales on a GAAP basis.

Reconciliations of each of these non-GAAP financial measures to the corresponding GAAP financial measure are included in the relevant sections of this Quarterly Report.

Management uses these supplemental non-GAAP financial measures to evaluate performance period over period, to analyze the underlying trends in our business, to assess our performance relative to our competitors and to establish operational goals and forecasts that are used in allocating resources. In addition, management uses these non-GAAP financial measures to further its understanding of the performance of our operating segments. The adjustments excluded from our non-GAAP financial measures are consistent with those excluded from our operating segments’ measures of net sales and profit or loss. These adjustments are excluded from the segment measures reported to our chief operating decision maker that are used to make operating decisions and assess performance.
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We believe that presenting adjusted net income (loss), adjusted net income (loss) available to common stockholders, adjusted net income (loss) per share, operational net sales and organic net sales growth rates, in addition to the corresponding GAAP financial measures, provides investors greater transparency to the information used by management for its operational decision-making and allows investors to see our results “through the eyes” of management. We further believe that providing this information assists our investors in understanding our operating performance and the methodology used by management to evaluate and measure such performance.

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Safe Harbor for Forward-Looking Statements

Certain statements that we may make from time to time, including statements contained in this Quarterly Report on Form 10-Q and information incorporated by reference herein, constitute “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934. Forward-looking statements may be identified by words like “anticipate,” “expect,” “project,” “believe,” “plan,” “may,”, “estimate,” “intend,” “aim”“aim,” "goal," "target," "continue," "hope" and similar words. These forward-looking statements are based on our beliefs, assumptions and estimates using information available to us at the time and are not intended to be guarantees of future events or performance. If our underlying assumptions turn out to be incorrect, or if certain risks or uncertainties materialize, actual results could vary materially from the expectations and projections expressed or implied by our forward-looking statements.

The forward-looking statements in this Quarterly Report on Form 10-Q are based on certain risks and uncertainties, including the risk factors described in Part I, Item 1A. Risk Factors in our most recent Annual Report on Form 10-K and the specific risk factors discussed herein and in connection with forward-looking statements throughout this Quarterly Report on Form 10-Q, which could cause actual results to vary materially from the expectations and projections expressed or implied by our forward-looking statements. These risks and uncertainties, in some cases, have affected and in the future could affect our ability to implement our business strategy and may cause actual results to differ materially from those contemplated by the statements expressed in this Quarterly Report.Report on Form 10-Q. As a result, readers are cautioned not to place undue reliance on any of our forward-looking statements. Risks and uncertainties that may cause such differences include, among other things: the impact of the ongoing COVID-19 pandemic on our operations and financial results; the impact of foreign currency fluctuations; future U.S. and global economic, political, competitive, reimbursement and regulatory conditions;conditions, including as a result of the ongoing conflict between Russia and Ukraine; manufacturing, distribution and supply chain disruptions and cost increases; disruptions caused by cybersecurity events; disruptions caused by extreme weather or other climate change-related events; labor shortages and increases in labor costs; new product introductions and the market acceptance of those products; markets for our products; expected pricing environment; expected procedural volumes; the closing and integration of acquisitions; clinical trial results; demographic trends; intellectual property rights; litigation; financial market conditions; the execution and effect of our restructuring program; the execution and effect of our business strategy, including our cost-savings and growth initiatives; our ability to achieve environmental, social and governance goals and commitments; and future business decisions made by us and our competitors. New risks and uncertainties may arise from time to time and are difficult to predict, including those that have emerged or have increased in significance or likelihood as a result of the COVID-19 pandemic. All of these factors are difficult or impossible to predict accurately and many of them are beyond our control. For a further list and description of these and other important risks and uncertainties that may affect our future operations, seerefer to Part I, Item 1A. Risk Factors in our most recent Annual Report on Form 10-K filed with the SEC, which we may update in Part II, Item 1A. Risk Factors in subsequent Quarterly Reports on Form 10-Q that we will file hereafter, and Part II, Item 1A. Risk Factors in this Quarterly Report on Form 10-Q.hereafter. We disclaim any intention or obligation to publicly update or revise any forward-looking statement to reflect any change in our expectations or in events, conditions, or circumstances on which those expectations may be based, or that may affect the likelihood that actual results will differ from those contained in the forward-looking statements. This cautionary statement is applicable to all forward-looking statements contained in this Quarterly Report.

The following are some of the important risk factors that could cause our actual results to differ materially from our expectations in any forward-looking statements. For further discussion of these and other risk factors, seerefer to Part I, Item 1A. Risk Factors in our most recent Annual Report on Form 10-K and Part II, Item 1A. Risk Factors in this Quarterly Report on Form 10-Q.10-K.

Our Businesses
The impact of the COVID-19 pandemic on the worldwide economy and financial markets, and developments related to the disease,

The impact of the COVID-19 pandemic on our global manufacturing and distribution system, including disruption in the time it will take for vaccinesmanufacture or supply of certain components, materials or products, or the failure to be broadly produced, distributed and administered worldwide,secure in a timely manner alternative manufacturing or additional or replacement components, materials or products,

Labor shortages and the effectivenessimpact of such vaccines in slowing or stoppinginflation on the spreadcost of COVID-19raw materials and variants thereof and mitigatingdirect labor, including as a result of the economic effects of the COVID-19 pandemic,

The impact of the COVID-19 pandemic upon the scheduling of elective and semi-emergent procedures,

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The impact of the COVID-19 pandemic on our global manufacturing and distribution system, including the quality of our products, availability and cost of raw materials and direct labor,

Our ability to recover from the impact of the COVID-19 pandemic on our business and increase net sales, expand the markets in which we participate, capture market share and adapt to market volatility,

The impact of natural disasters, climate change, additional future public health crises and other catastrophic events on our ability to manufacture, distribute and sell our products,
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Competitive offerings and related declines in average selling prices for our products,

The ongoing impact on our business of physician alignment to hospitals, governmental investigations and audits of hospitals and other market and economic conditions on the overall number of procedures performed,

The performance of, and physician and patient confidence in, our products and technologies or those of our competitors,

The impact and outcome of ongoing and future clinical trials and market studies undertaken by us, our competitors or other third parties or perceived product performance of our or our competitors' products,
 
Variations in clinical results, reliability or product performance of our and our competitors' products,

Our ability to acquire or develop, launch and supply new or next-generation products and technologies worldwide and in line with our commercialization strategies in a timely and successful manner and with respect to our recent acquisitions,

The effect of consolidation and competition in the markets in which we do business or plan to do business,

Disruption in the manufacture or supply of certain components, materials or products, or the failure to secure in a timely manner alternative manufacturing or additional or replacement components, materials or products,

Our ability to achieve our projected level or mix of product sales, as some of our products are more profitable than others,

Our ability to attract and retain talent, including key personnel including those associated with recent acquisitions, and to maintain our robust corporate culture, especially in light of the remote working conditions imposed by the COVID-19 pandemic, and execute plans to return employees to offices in jurisdictions where safe and feasible,

The inability of certain of our employees to return to work full timefull-time due to impacts of the COVID-19 pandemic, or our inability to recruit personnel into direct labor roles for the duration of the pandemic,

The impact of enhanced requirements to obtain and maintain regulatory approval in the U.S. and around the world, including EU MDR and the associated timing and cost of product approval,
 
The impact of increased pressure on the availability and rate of third-party reimbursement for our products and procedures in the U.S. and around the world, including with respect to the timing and costs of creating and expanding markets for new products and technologies,

The issuance of new or revised accounting standards by the Financial Accounting Standards Board or the Securities and Exchange Commission, and

The impact of potential goodwill and intangible asset impairment charges on our results of operations.

Regulatory Compliance, Litigation and Data Protection

The impact of healthcare policy changes and legislative or regulatory efforts in the U.S., the EU and around the world to modify product approval or reimbursement processes, including a trend toward demonstrating clinical outcomes, comparative effectiveness and cost efficiency, as well as the impact of other healthcare reform legislation,
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Risks associated with our regulatory compliance and quality systems and activities in the U.S., the EU and around the world, including meeting regulatory standards applicable to manufacturing and quality processes,

The effect of global legal, regulatory or market responses to global climate change, including increased compliance burdens and costs to meet regulatory obligations,

Our ability to minimize or avoid future field actions or FDA warning letters relating to our products and processes and the ongoing inherent risk of potential physician advisories related to our or our competitors' products,

The impact of increased scrutiny of and heightened global regulatory enforcement facing the medical device industry arising from political and regulatory changes, economic pressures or otherwise, including under U.S. Anti-Kickback
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Statute, U.S. False Claims Act and similar laws in other jurisdictions, U.S. Foreign Corrupt Practices Act (FCPA) and similar laws in other jurisdictions, and U.S. and foreign export control, trade embargo and customs laws,

Costs and risks associated with current and future asserted litigation,

The effect of our litigation and risk management practices, including self-insurance and compliance activities on our loss contingencies, legal provisionprovisions and cash flows,
 
The impact of, diversion of management attention as a result of, and costs to cooperate with, litigate and/or resolve governmental investigations and our class action, product liability, contract and other legal proceedings,

The possibility of failure to protect our intellectual property rights and the outcome of patent litigation,

Our ability to operate properly our information systems that support our business operations and protect our data integrity and products from a cyber-attack or other breach that has a material adverse effect on our business, reputation or results of operationsincluding increased risks as an indirect result of the ongoing conflict between Russia and Ukraine, and

The potential impact to internal control over financial reporting relating to potential restrictions to access to consigned inventory at customer locations for our inventory count procedures.

Innovation and Certain Growth Initiatives

The timing, size and nature of our strategic growth initiatives and market opportunities, including with respect to our internal research and development platforms and externally available research and development platforms and technologies and the ultimate cost and success of those initiatives and opportunities,

Our ability to complete planned clinical trials successfully, obtain regulatory approvals and launch new and next generation products in a timely manner consistent with cost estimates, including the successful completion of projects from in-process research and development,

Our ability to identify and prioritize our internal research and development project portfolio and our external investment portfolio on profitable net sales growth opportunities as well as to maintain the estimated timing and costs of such projects and expected revenue levels for the resulting products and technologies,

Our ability to develop, manufacture and market new products and technologies successfully and in a timely manner and the ability of our competitors and other third parties to develop products or technologies that render our products or technologies noncompetitive or obsolete,

Our ability to execute appropriate decisions to discontinue, write-down or reduce the funding of any of our research and development projects, including projects from in-process research and development from our acquisitions, in our growth adjacencies or otherwise,

Our dependence on acquisitions, alliances or investments to introduce new products or technologies and to enter new or adjacent growth markets and our ability to fund them or to fund contingent payments with respect to those acquisitions, alliances and investments, and

The potential failure to successfully integrate and realize the expected benefits, including cost synergies, from the strategic acquisitions, alliances and investments we have consummated or may consummate in the future.
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International Markets

Our dependency on international net sales to achieve growth, including in emerging markets,

The timing and collectability of customer payments, as well as our ability to continue factoring customer receivables where we have factoring arrangements, or to enter new factoring arrangements with favorable terms,

The impact on pricing due to national and regional tenders,
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Geopolitical and economic conditions, including civil unrest, terrorist activity, governmental changes, restrictions on the ability to transfer capital across borders, tariffs and other protectionist measures,

The impact of the United Kingdom’s departure fromRussia/Ukraine conflict,and related, downstream effects thereof, including the European Union,impact of sanctions on U.S. manufacturers doing business in these regions,

Protection of our intellectual property,

Our ability to comply with established and developing U.S. and foreign legal and regulatory requirements, including FCPA, EU MDR and similar laws in other jurisdictions,

Our ability to comply with U.S. and foreign export control, trade embargo and customs laws,

The impact of changes in reimbursement practices and policies,

The impact of significant developments or uncertainties stemming from changes in the U.S. administrationgovernment following the 2020 presidential and congressional elections, including changes in U.S. trade policies, tariffs and the reaction of other countries thereto, particularly China,

Our ability to maintain or expand our worldwide market positions in the various markets in which we compete or seek to compete, including through investments in product diversification and emerging markets such as Brazil, Russia, India and China,

Our ability to execute and realize anticipated benefits from our investments in emerging markets, and

The potential effect of foreign currency fluctuations and interest rate fluctuations on our net sales, expenses and resulting margins.

Liquidity

Our ability to generate sufficient cash flow to fund operations, capital expenditures, global expansion initiatives, any litigation settlements and judgments, share repurchases and strategic investments and acquisitions as well as maintaining our investment grade ratings and managing our debt levels and financial covenant compliance, particularly in light of the COVID-19 pandemic and lower demand for our products,

Our ability to access the public and private capital markets when desired and to issue debt or equity securities on terms reasonably acceptable to us,

The unfavorable resolution of open tax matters, exposure to additional tax liabilities and the impact of changes in U.S. and international tax laws,

The unfavorable resolution of open litigation matters, exposure to additional loss contingencies and legal provisions,

The impact of examinations and assessments by domestic and international taxing authorities on our tax provision,provisions, financial condition or results of operations,

The possibility of counterparty default on our derivative financial instruments, and

Our ability to collect outstanding and future receivables and/or sell receivables under our factoring programs.

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Cost Reduction and Optimization Initiatives

Risks associated with changes made or expected to be made to our organizational and operational structure, pursuant to our restructuring plans as well as any further restructuring or optimization plans we may undertake in the future and our ability to recognize benefits and cost reductions from such programs and

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Business disruption and employee distraction as we execute our global compliance program, restructuring and optimization plans and divestitures of assets or businesses and implement our other strategic and cost reduction initiatives.
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ITEM 3.QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
We develop, manufacture and sell medical devices globally and our earnings and cash flows are exposed to market risk from changes in currency exchange rates and interest rates. We address these risks through a risk management program that includes the use of derivative financial instruments. We operate the program pursuant to documented corporate risk management policies. We do not enter derivative transactions for speculative purposes. Gains and losses on derivative financial instruments substantially offset losses and gains on underlying hedged exposures. Furthermore, 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.
Our currency risk consists primarily of foreign currency denominated firm commitments, forecasted foreign currency denominated intercompany and third-party transactions and net investments in certain subsidiaries. We use both nonderivative (primarily European manufacturing operations) and derivative instruments to manage our earnings and cash flow exposure to changes in currency exchange rates. We had currency derivative instruments outstanding in the contract amount of $9.675$6.920 billion as of SeptemberJune 30, 20212022 and $10.481$8.381 billion as of December 31, 2020.2021. A ten percent appreciation in the U.S. dollar’s value relative to the hedged currencies would increase the derivative instruments’ fair value by $333$264 million as of SeptemberJune 30, 20212022 as compared to $333$298 million as of December 31, 2020.2021. A ten percent depreciation in the U.S. dollar’s value relative to the hedged currencies would decrease the derivative instruments’ fair value by $408$323 million as of SeptemberJune 30, 20212022 as compared to $407$364 million as of December 31, 2020.2021. Any increase or decrease in the fair value of our currency exchange rate sensitive derivative instruments would be substantially offset by a corresponding decrease or increase in the fair value of the hedged underlying asset, liability or forecasted transaction, resulting in minimal impacts on our unaudited consolidated statements of operations.
Our interest rate risk relates primarily to U.S. dollar borrowings partially offset by U.S. dollar cash investments. We have historically used interest rate derivative instruments to manage our earnings and cash flow exposure to changes in interest rates. We had no interest rate derivative instruments outstanding as of SeptemberJune 30, 20212022 and December 31, 2020.2021. As of SeptemberJune 30, 2021, $9.1432022, $8.878 billion in aggregate principal amount of our outstanding debt obligations werewas at fixed interest rates, representing approximately 10098 percent of our total debt, on an amortized cost basis. As of SeptemberJune 30, 2021,2022, our outstanding debt obligations at fixed interest rates were comprised of senior notes.

Refer to Note D – Hedging Activities and Fair Value Measurements to our unaudited consolidated financial statements contained in Item 1 of this Quarterly Report on Form 10-Q for further information regarding our derivative financial instruments.

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ITEM 4.CONTROLS AND PROCEDURES

Evaluation of Disclosure Controls and Procedures

Our management, with the participation of our Chief Executive Officer (CEO) and our Chief Financial Officer (CFO), evaluated the effectiveness of our disclosure controls and procedures as of SeptemberJune 30, 20212022 pursuant to Rule 13a-15(b) of the Securities Exchange Act of 1934, as amended (the Exchange Act). Disclosure controls and procedures are designed to ensure that material information required to be disclosed by us in the reports that we file or submit under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms and that such material information is accumulated and communicated to our management, including our CEO and CFO, as appropriate, to allow timely decisions regarding required disclosure. Based on their evaluation, our CEO and CFO concluded that, as of SeptemberJune 30, 2021,2022, our disclosure controls and procedures were effective.

Changes in Internal Control Over Financial Reporting

There were no changes in our internal control over financial reporting in the thirdsecond quarter or first six months of 20212022 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting. Further, while many

A multi-year implementation of a new global enterprise resource planning (ERP) system is in progress and will replace our employees continuedexisting ERP system. The implementation is expected to work remotelyoccur in phases over the next several years. As the phased implementation occurs, it will result in changes to adhereour processes and procedures which will include changes to COVID-19 social distancing requirements, this did not affect our ability to maintain financial reporting systems, internal controls over financial reporting or disclosure controls and procedures. Prior to the COVID-19 pandemic,reporting. As such changes occur, we were leveraging electronic tools to facilitatewill evaluate quarterly whether they materially affect our global close process and to connect our physically dispersed team of finance professionals in offices around the world. While the quarterly close cycle was performed remotely, fundamentally, the work performed, and the processes and controls executed did not change.internal control over financial reporting.

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PART II
OTHER INFORMATION

ITEM 1. LEGAL PROCEEDINGS

SeeRefer to Note G – Income Taxes and Note H – Commitments and Contingencies to our unaudited consolidated financial statements contained in Item 1 of this Quarterly Report on Form 10-Q, which is incorporated herein by reference.

ITEM 1A. RISK FACTORS

In addition to other information contained elsewhere in this report, you should carefully consider the factors discussed in Part I, Item 1A. Risk Factors in our most recent Annual Report filed on Form 10-K, which could materially affect our business, financial condition or future results.

ITEM 6. EXHIBITS (* documents filed or furnished with this report,)report)
4.1
4.2
4.3
4.4
4.5
10.1
10.2
22
31.1* 
 
31.2* 
 
32.1* 
 
32.2* 
 
101.SCH*XBRL Taxonomy Extension Schema Document.
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101.CAL*XBRL Taxonomy Extension Calculation Linkbase Document.
101.DEF*XBRL Taxonomy Extension Definition Linkbase Document.
101.LAB*XBRL Taxonomy Extension Label Linkbase Document.
101.PRE*XBRL Taxonomy Extension Presentation Linkbase Document.
104Cover Page Interactive Data File (embedded within the Inline XBRL document and contained in Exhibit 101).
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SIGNATURE
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized on NovemberAugust 4, 2021.2022.

 
BOSTON SCIENTIFIC CORPORATION
 
 By:/s/ Daniel J. Brennan
   
  Name:Daniel J. Brennan
  Title:Executive Vice President and
Chief Financial Officer 
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