UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
_________________________
Form 10-Q
(Mark One)
þ

QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d)
OF THE SECURITIES EXCHANGE ACT OF 1934
 For the quarterly period ended September 30, 2017March 31, 2019
 or
¨
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d)
OF THE SECURITIES EXCHANGE ACT OF 1934
 For the transition period from _______________ to _______________
Commission file number: 001-37599
lnlogomain280x75.jpg
LivaNova PLC
(Exact name of registrant as specified in its charter)
England and Wales98-1268150
(State or other jurisdiction of
incorporation or organization)
(I.R.S. Employer
Identification No.)
20 Eastbourne Terrace
London, United Kingdom
W2 6LG
(Address of principal executive offices)

(Zip Code)

(44) (0) 20 3325 0660 
Registrant’s telephone number, including area code:

 

Securities registered pursuant to Section 12(b) of the Act:

Securities registered pursuant to Section 12(b) of the Act
Title of each classTrading Symbol(s)Name of each exchange on which registered
Ordinary Shares - £1.00 par value per shareThe LIVNNASDAQ StockGlobal Market LLC
Title of Each Class of StockName of Each Exchange on Which Registered

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 þ     No ¨
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted 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 and post such files).  Yes þ    No ¨
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer”filer,” “smaller reporting company” and “smaller reporting“emerging growth company” in Rule 12b-2 of the Exchange Act.
 
Large accelerated filer
þ

Accelerated filer¨
Non-accelerated filer
¨ (Do not check if a smaller reporting company)
Smaller reporting company¨
Emerging growth company¨  
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act

¨
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act).  Yes ¨     No þ
ClassOutstanding at October 27, 2017April 29, 2019
Ordinary Shares - £1.00 par value per share48,211,55948,320,894


LIVANOVA PLC
TABLE OF CONTENTS
  PART I. FINANCIAL INFORMATION PAGE NO.
   
  
   
   
   
   
   
  
  
  
  PART II. OTHER INFORMATION  
  
  
 

 
  
  
  
  
In this Quarterly Report on Form 10-Q, “LivaNova,” “the Company,” “we,” “us” and “our” refer to LivaNova PLC and its consolidated subsidiaries.
This report may contain references to our proprietary intellectual property, including among others:
Trademarks for our VNS therapy systems, the VNS Therapy® System, the VITARIA® System and our proprietary pulse generator products: Model 102 (Pulse®), Model 102R (Pulse Duo®), Model 103 (Demipulse®), Model 104 (Demipulse Duo®), Model 105 (AspireHC®), Model 106 (AspireSR®) and Model 1000 (SenTiva™).
Trademarks for our oxygenator product systems: Inspire™, Heartlink™ and Connect™.
Trademarks for our line of surgical tissue and mechanical valve replacements and repair products: Mitroflow™, Crown PRT™, Solo Smart™, Perceval™, Top Hat™, Reduced Series Aortic Valves™, Carbomedics Carbo-Seal™, Carbo-Seal Valsalva™, Carbomedics Standard™, Orbis™ and Optiform™, and Mitral valve repair products: Memo 3D™, Memo 3D ReChord™, AnnuloFlo™ and AnnuloFlex™.
Trademarks for our implantable cardiac pacemakers and associated services: REPLY 200™, ESPRIT™, KORA 100™, KORA 250™, SafeR™, the REPLY CRT-P™, the remedéCardiopulmonary product systems: S5® System.heart-lung machine, S3® heart-lung machine, Inspire™, Heartlink™, XTRA® Autotransfusion System, 3T Heater-Cooler® Connect™ and Revolution®.
Trademarks for our Implantable Cardioverter Defibrillatorsline of surgical tissue and associated technologies: the INTENSIA™, PLATINIUM™,mechanical valve replacements and PARADYM®product families.
Trademarks for our cardiac resynchronization therapy devices, technologies services: SonRrepair products: Mitroflow®, SonRtip™Crown PRT®, Solo Smart™, Perceval®, Top Hat®, Reduced Series Aortic Valves™, Carbomedics® SonR CRT™, the INTENSIA™, PARADYM RF™, PARADYM 2™Carbo-Seal®, Carbo-Seal Valsalva®, Carbomedics® Standard™, Orbis™ and PLATINIUM™ product familiesOptiform®, Memo 3D®, Memo 3D® ReChord™, MEMO 4D®, MEMO 4D® ReChord™, AnnuloFlo®, AnnuloFlex®, Bicarbon Slimline™, Bicarbon Filtline™ and the Respond CRT™ clinical trial.
Trademarks for heart failure treatment product: EquiliaBicarbon Overline®.
Trademarks for our bradycardia leads: BEFLEX™ (active fixation) and XFINE™ (passive fixation).
These trademarks and tradenamestrade names are the property of LivaNova or the property of our consolidated subsidiaries and are protected under applicable intellectual property laws. Solely for convenience, our trademarks and tradenames referred to in this Quarterly Report on Form 10-Q may appear without the ® or symbols, but such references are not intended to indicate in any way that we will not assert, to the fullest extent under applicable law, our rights to these trademarks and tradenames.



NOTE ABOUT FORWARD LOOKING STATEMENTS
Certain statements in this Quarterly Report on Form 10-Q, other than purely historical information, are “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995, Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”). These statements include, but are not limited to, LivaNova’s plans, objectives, strategies, financial performance and outlook, trends, the amount and timing of future cash distributions, prospects or future events and involve known and unknown risks that are difficult to predict. As a result, our actual financial results, performance, achievements or prospects may differ materially from those expressed or implied by these forward-looking statements. In some cases, you can identify forward-looking statements by the use of words such as “may,” “could,” “seek,” “guidance,” “predict,” “potential,” “likely,” “believe,” “will,” “should,” “expect,” “anticipate,” “estimate,” “plan,” “intend,” “forecast,” “foresee” or variations of these terms and similar expressions, or the negative of these terms or similar expressions. Such forward-looking statements are necessarily based on estimates and assumptions that, while considered reasonable by LivaNova and its management based on their knowledge and understanding of the business and industry, are inherently uncertain. These statements are not guarantees of future performance, and stockholders should not place undue reliance on forward-looking statements. There are a number of risks, uncertainties and other important factors, many of which are beyond our control, that could cause our actual results to differ materially from the forward-looking statements contained in this Quarterly Report on Form 10-Q, and include but are not limited to the risks and uncertainties summarized below:
Risks related to our business:
changes in our common stock price;
changes in our profitability;
regulatory activities and announcements, including the failure to obtain regulatory approvals for our new products;
effectiveness of our internal controls over financial reporting;
fluctuations in future quarterly operating results;
failure to comply with, or changes in, laws, regulations or administrative practices affecting government regulation of our products, including, but not limited to, U.S. Food and Drug Administration (“FDA”) laws and regulations;
failure to establish, expand or maintain market acceptance of our products for the treatment of our approved indications;
any legislative or administrative reform to the healthcare system, including the U.S. Medicare or Medicaid systems or international reimbursement systems, that significantly reduces reimbursement for our products or procedures or denies coverage for such products or procedures or enhances coverage for competitive products or procedures, as well as adverse decisions by administrators of such systems on coverage or reimbursement issues relating to our products;
failure to maintain the current regulatory approvals for our products’ approved indications;
failure to obtain or maintain coverage and reimbursement for our products’ approved indications;
unfavorable results from clinical studies;
variations in sales and operating expenses relative to estimates;
our dependence on certain suppliers and manufacturers to provide certain materials, components and contract services necessary for the production of our products;
product liability, intellectual property, shareholder-related, environmental-related, income tax and other litigation, disputes, losses and costs;
protection, expiration and validity of our intellectual property;
changes in technology, including the development of superior or alternative technology or devices by competitors;
competition from providers of alternative medical therapies, such as pharmaceutical companies and providers of cannabis;
cyber-attacks or other disruptions to our information technology systems;
failure to comply with applicable U.S. domestic laws and regulations, including federal and state privacy and security laws and regulations;
failure to comply with applicable non-U.S. lawlaws and regulations;
non-U.S. operational and economic risks and concerns;


failure to attract or retain key personnel;


failure of new acquisitions to further our strategic objectives or strengthen our existing businesses;
losses or costs from pending or future lawsuits and governmental investigations;
changes in accounting rules that adversely affect the characterization of our consolidated financial position, results of operations or cash flows;
changes in customer spending patterns;
continued volatility in the global market and worldwide economic conditions, including volatility caused by the implementation of Brexit;Brexit and/or changes to existing trade agreements and relationships between the U.S. and other countries;
changes in tax laws, including changes related to Brexit, or exposure to additional income tax liabilities;
harsh weather or natural disasters that interrupt our business operations or the business operations of our hospital-customers; and
failure of the market to adopt new therapies or to adopt new therapies quickly.
Other factors that could cause our actual results to differ from our projected results are described in (1) “Part II, Item 1A. Risk Factors” and elsewhere in this Quarterly Report on Form 10-Q, (2) our Annual Report on Form 10-K for the fiscal year ended December 31, 20162018 (“20162018 Form 10-K”), (3) our reports and registration statements filed and furnished from time to time with the SECSecurities and Exchange Commission (“SEC”) and (4) other announcements we make from time to time.
Readers are cautioned not to place undue reliance on forward-looking statements, which speak only as of the date hereof. We undertake no obligation to update or revise any forward-looking statements after the date they are made, whether as a result of new information, future events or otherwise. You should read the following discussion and analysis in conjunction with our unaudited condensed consolidated financial statements and related notes included elsewhere in this report. Operating results for the three and nine months ended September 30, 2017March 31, 2019 are not necessarily indicative of future results, including the full fiscal year. You should also refer to our “Annual Consolidated Financial Statements,” “Notes” thereto, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” and “Risk Factors” contained in our 20162018 Form 10-K.
Financial Information and Currency of Financial Statements
All of the financial information included in this quarterly report has been prepared in accordance with generally accepted accounting principles generally accepted in the United States or of America (“U.S. GAAP.” and such principles, “U.S. GAAP”). The reporting currency of our condensed consolidated financial statements is U.S. dollars.




PART I. FINANCIAL INFORMATION
Item 1. Financial Statements
LIVANOVA PLC AND SUBSIDIARIES’SUBSIDIARIES
CONDENSED CONSOLIDATEDSTATEMENTS OF INCOME (LOSS)
(UNAUDITED)
(In thousands, except per share amounts)
  Three Months Ended September 30, Nine Months Ended September 30,
  2017 2016 2017 2016
Net sales $309,664
 $295,268
 $916,156
 $903,284
Cost of sales 108,233
 106,454
 318,584
 360,675
Product remediation 1,642
 689
 2,573
 2,243
Gross profit 199,789
 188,125
 594,999
 540,366
Operating expenses:        
Selling, general and administrative 121,177
 109,233
 353,943
 345,744
Research and development 31,393
 32,175
 104,051
 94,076
Merger and integration expenses 2,013
 7,576
 7,743
 20,537
Restructuring expenses 792
 4,381
 12,060
 37,219
Amortization of intangibles 12,350
 11,775
 35,445
 33,959
Total operating expenses 167,725
 165,140
 513,242
 531,535
Income from operations 32,064
 22,985
 81,757
 8,831
Interest income 199
 585
 724
 1,119
Interest expense (1,421) (3,495) (5,314) (6,665)
Gain on acquisition of Caisson Interventional, LLC 
 
 39,428
 
Foreign exchange and other gains (losses) 491
 1,216
 957
 (2)
Income before income taxes 31,333
 21,291
 117,552
 3,283
Income tax expense 1,913
 9,731
 10,881
 16,891
Losses from equity method investments (1,590) (13,129) (20,072) (19,382)
Net income (loss) $27,830
 $(1,569) $86,599
 $(32,990)
         
Basic income (loss) per share $0.58
 $(0.03) $1.80
 $(0.67)
Diluted income (loss) per share $0.57
 $(0.03) $1.79
 $(0.67)
Shares used in computing basic income (loss) per share 48,181
 49,075
 48,130
 49,016
Shares used in computing diluted income (loss) per share 48,534
 49,075
 48,339
 49,016
  Three Months Ended March 31,
  2019 2018
Net sales $250,801
 $250,398
Costs and expenses:    
Cost of sales - exclusive of amortization 84,254
 84,598
Product remediation 2,947
 3,715
Selling, general and administrative 125,704
 104,161
Research and development 43,575
 31,752
Merger and integration expenses 3,251
 2,960
Restructuring expenses 2,533
 1,881
Amortization of intangibles 9,316
 8,801
Operating (loss) income from continuing operations (20,779) 12,530
Interest income 249
 447
Interest expense (1,662) (2,111)
Gain on acquisition 
 11,484
Foreign exchange and other gains (losses) 729
 (273)
(Loss) income from continuing operations before tax (21,463) 22,077
Income tax (benefit) expense (6,614) 3,893
Losses from equity method investments 
 (362)
Net (loss) income from continuing operations (14,849) 17,822
Net loss from discontinued operations, net of tax 
 (4,549)
Net (loss) income $(14,849) $13,273
     
Basic (loss) income per share:    
Continuing operations $(0.31) $0.37
Discontinued operations 
 (0.10)
  $(0.31) $0.27
     
Diluted (loss) income per share:    
Continuing operations $(0.31) $0.36
Discontinued operations 
 (0.09)
  $(0.31) $0.27
     
Shares used in computing basic (loss) income per share 48,246
 48,324
Shares used in computing diluted (loss) income per share 48,246
 49,187


LIVANOVA PLC AND SUBSIDIARIES’SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS)
(UNAUDITED)
(In thousands)
  Three Months Ended September 30, Nine Months Ended September 30,
  2017 2016 2017 2016
Net income (loss) $27,830
 $(1,569) $86,599
 $(32,990)
Other comprehensive income (loss):        
Net change in unrealized gain (loss) on derivatives (1,980) 2,042
 (5,923) (5,224)
Tax effect 473
 (673) 1,756
 1,513
Net of tax (1,507) 1,369
 (4,167) (3,711)
Foreign currency translation adjustment, net of tax 39,106
 (1,805) 111,123
 32,598
Total other comprehensive income (loss) 37,599
 (436) 106,956
 28,887
Total comprehensive income (loss) $65,429
 $(2,005) $193,555
 $(4,103)
  Three Months Ended March 31,
  2019 2018
Net (loss) income $(14,849) $13,273
Other comprehensive (loss) income:    
Net change in unrealized loss on derivatives (10) (1,257)
Tax effect 2
 302
Net of tax (8) (955)
Foreign currency translation adjustment, net of tax (4,229) 10,553
Total other comprehensive (loss) income (4,237) 9,598
Total comprehensive (loss) income $(19,086) $22,871



LIVANOVA PLC AND SUBSIDIARIES’SUBSIDIARIES
CONDENSED CONSOLIDATED BALANCE SHEETS
(In thousands, except share amounts)
(UNAUDITED)
 September 30, 2017 December 31, 2016
 (Unaudited)   March 31, 2019 December 31, 2018
ASSETS        
Current Assets:        
Cash and cash equivalents $65,158
 $39,789
 $50,776
 $47,204
Accounts receivable, net 314,041
 275,730
Accounts receivable, net of allowance of $11,484 at March 31, 2019 and $11,598 at
December 31, 2018
 247,059
 256,135
Inventories 214,593
 183,489
 161,267
 153,535
Prepaid and refundable taxes 58,969
 60,615
 47,225
 46,852
Assets held for sale 14,117
 4,477
Prepaid expenses and other current assets 55,176
 55,973
 34,275
 29,571
Total Current Assets 722,054
 620,073
 540,602
 533,297
Property, plant and equipment, net 213,769
 223,842
 185,947
 191,400
Goodwill 781,070
 691,712
 952,117
 956,815
Intangible assets, net 717,646
 609,197
 758,528
 770,439
Operating lease assets (Note 10) 57,070
 
Investments 46,380
 61,092
 24,762
 24,823
Deferred tax assets, net 4,356
 6,017
Deferred tax assets 74,876
 68,146
Other assets 117,855
 130,698
 5,642
 4,781
Total Assets $2,603,130
 $2,342,631
 $2,599,544
 $2,549,701
LIABILITIES AND STOCKHOLDERS' EQUITY        
Current Liabilities:        
Current debt obligations $52,074
 $47,650
 $39,442
 $28,794
Accounts payable 102,651
 92,952
 80,199
 76,735
Accrued liabilities and other 92,212
 75,567
 150,536
 124,285
Current litigation provision liability 252,051
 161,851
Taxes payable 28,954
 22,340
 9,834
 22,530
Accrued employee compensation and related benefits 80,466
 78,302
 90,248
 82,551
Total Current Liabilities 356,357
 316,811
 622,310
 496,746
Long-term debt obligations 71,853
 75,215
 141,850
 139,538
Deferred income taxes liability 152,133
 172,541
Contingent consideration 147,080
 161,381
Litigation provision liability 42,000
 132,210
Deferred tax liabilities 73,143
 68,189
Long-term operating lease liabilities (Note 10) 47,227
 
Long-term employee compensation and related benefits 33,957
 31,668
 22,551
 25,264
Other long-term liabilities 74,404
 39,487
 16,577
 22,635
Total Liabilities 688,704
 635,722
 1,112,738
 1,045,963
Commitments and contingencies (Note 9) 
 
Commitments and contingencies (Note 11) 
 
Stockholders’ Equity:        
Ordinary Shares, £1.00 par value: unlimited shares authorized; 48,250,361 shares issued and 48,200,257 shares outstanding at September 30, 2017; 48,156,690 shares issued and 48,028,413 shares outstanding at December 31, 2016 74,697
 74,578
Ordinary Shares, £1.00 par value: unlimited shares authorized; 49,329,119 shares issued and 48,318,226 shares outstanding at March 31, 2019; 49,323,418 shares issued and 48,205,783 shares outstanding at December 31, 2018 76,151
 76,144
Additional paid-in capital 1,731,565
 1,719,893
 1,707,117
 1,705,111
Accumulated other comprehensive income (loss) 38,469
 (68,487)
Retained earnings (deficit) 72,024
 (14,575)
Treasury stock at cost, 50,104 shares at September 30, 2017 and 128,277 shares at December 31, 2016 (2,329) (4,500)
Accumulated other comprehensive loss (28,713) (24,476)
Accumulated deficit (266,428) (251,579)
Treasury stock at cost, 1,010,893 shares at March 31, 2019 and 1,117,635 shares at December 31, 2018 (1,321) (1,462)
Total Stockholders’ Equity 1,914,426
 1,706,909
 1,486,806
 1,503,738
Total Liabilities and Stockholders’ Equity $2,603,130
 $2,342,631
 $2,599,544
 $2,549,701


LIVANOVA PLC AND SUBSIDIARIES’SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(UNAUDITED)
(In thousands)
 Nine Months Ended September 30, Three Months Ended March 31,
 2017 2016 2019 2018
Operating Activities:  
  
    
Net income (loss) $86,599
 $(32,990)
Non-cash items included in net income (loss):    
Net (loss) income $(14,849) $13,273
Non-cash items included in net (loss) income:    
Depreciation 27,880
 30,193
 7,547
 8,334
Amortization 35,445
 33,959
 9,316
 8,802
Stock-based compensation 14,261
 15,575
 6,872
 6,680
Deferred income tax benefit (27,270) (10,224)
Deferred tax expense (benefit) 1,993
 (922)
Losses from equity method investments 20,072
 19,382
 
 1,573
Gain on acquisition of Caisson Interventional, LLC (39,428) 
Impairment of property, plant and equipment 4,581
 
Gain on acquisition 
 (11,484)
Amortization of income taxes payable on inter-company transfers of property 23,831
 17,114
 1,411
 1,979
Remeasurement of contingent consideration to fair value 9,457
 673
Other 3,364
 8,765
 3,354
 (1,230)
Changes in operating assets and liabilities:        
Accounts receivable, net (19,107) (11,040) 7,064
 9,109
Inventories (11,006) 20,607
 (8,292) (6,305)
Other current and non-current assets (17,846) (25,845) (23,377) (16,691)
Accounts payable and accrued current and non-current liabilities 6,384
 5,697
Restructuring reserve (12,753) 14,961
 (4,906) 905
Accounts payable and accrued current and non-current liabilities (14,958) (31,109)
Net cash provided by operating activities 73,665
 49,348
 1,974
 20,393
Investing Activities:  
  
   

Acquisition, net of cash acquired 
 (77,629)
Purchases of property, plant and equipment and other (24,004) (28,928) (5,741) (5,846)
Acquisition of Caisson Interventional, LLC, net of cash acquired (14,194) 
Proceeds from sale of cost method investment 3,192
 
Proceeds from asset sales 5,346
 222
 100
 123
Purchases of cost and equity method investments (5,209) (8,059)
Loans to cost and equity method investees (6,928) (6,595)
Purchases of short-term investments 
 (7,054)
Maturities of short-term investments 
 14,051
Net cash used in investing activities (41,797) (36,363) (5,641) (83,352)
Financing Activities:        
Change in short-term borrowing, net (18,054) (33,831) 11,061
 15,503
Proceeds from short-term borrowing (maturities greater than 90 days) 20,000
 
 
 20,000
Repayment of long-term debt obligations (11,615) (11,354)
Proceeds from long-term debt obligations 2,973
 
Proceeds from exercise of stock options 3,221
 7,888
 119
 1,607
Repayment of trade receivable advances 
 (23,848)
Proceeds from long-term debt obligations 
 7,994
Share repurchases 
 (11,053)
Debt issuance costs (1,750) 
Shares repurchased from employees for minimum tax withholding (4,606) (4,919)
Other (3,552) 1,208
 (208) (144)
Net cash used in financing activities (10,000) (62,996)
Net cash provided by financing activities 7,589
 32,047
Effect of exchange rate changes on cash and cash equivalents 3,501
 1,030
 (350) 2,261
Net increase (decrease) in cash and cash equivalents 25,369
 (48,981) 3,572
 (28,651)
Cash and cash equivalents at beginning of period 39,789
 112,613
 47,204
 93,615
Cash and cash equivalents at end of period $65,158
 $63,632
 $50,776
 $64,964


LIVANOVA PLC AND SUBSIDIARIES
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)
Note 1. Unaudited Condensed Consolidated Financial Statements
Basis of Presentation
The accompanying condensed consolidated financial statements of LivaNova as of, and for the three and nine months ended September 30, 2017March 31, 2019 and September 30, 2016,March 31, 2018, have been prepared in accordance with generally accepted accounting principles in the United States of America (“U.S.” and such principles, “U.S. GAAP”) GAAP for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. The accompanying condensed consolidated balance sheet of LivaNova at December 31, 20162018 has been derived from audited financial statements contained in our 20162018 Form 10-K, but does not include all of the information and footnotes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments (consisting of only normal recurring adjustments) considered necessary for a fair presentationstatement of the operating results of LivaNova and its subsidiaries, for the three and nine months ended September 30, 2017,March 31, 2019 and are not necessarily indicative of the results that may be expected for the year ending December 31, 2017.2019. The financial information presented herein should be read in conjunction with the audited consolidated financial statements and notes thereto accompanying our 20162018 Form 10-K.
DescriptionThe accompanying condensed consolidated financial statements have been prepared on the basis that LivaNova will continue as a going concern. As further discussed in “Note 11. Commitments and Contingencies,” the Company recorded a $294.1 million litigation provision liability as of December 31, 2018 based on management’s best estimate, of which $161.9 million is anticipated to be paid during 2019 and the majority of the Mergers
On October 19, 2015 LivaNova becameremainder is expected to be paid in the holding companyfirst half of 2020. In connection with our assessment of going concern considerations as of the combined businessesissuance date of Cyberonics, Inc. (“Cyberonics”)our 2018 Form 10-K in accordance with ASU 2014-15, “Disclosures of Uncertainties about an Entity’s Ability to Continue as a Going Concern,” the Company determined that collectively the payments of the $294.1 million liability and Sorin S.p.A. (“Sorin”)the $23.3 million of current debt obligations represented a condition that raised substantial doubt about our ability to continue as a going concern. However, on February 25, 2019, the Company received $350 million in aggregate financing commitments pursuant to a commitment letter from Bank of America Merrill Lynch International DAC, Barclays Bank PLC, BNP Paribas and Intesa Sanpaolo S.P.A for a debt facility (the “Mergers”“Commitment Letter”). We concluded that the anticipated execution of the debt facility agreement based on the Commitment Letter, when combined with current and anticipated future operating cash flows, alleviated the substantial doubt about the Company’s ability to continue as a going concern over the 12-month period beginning from the issuance date of our 2018 Form 10-K. On March 26, 2019, we entered into a facility agreement that provides a multicurrency term loan facility in an aggregate principal amount of $350 million and terminates on March 26, 2022 (the “Facility Agreement”).
Based on our current business plan, we believe that our existing cash and cash equivalents, future cash generated from operations and borrowings will be sufficient to fund our expected operating needs, working capital requirements, R&D opportunities, capital expenditures, obligations anticipated for the structurelitigation involving our 3T device and debt service requirements over the 12-month period beginning from the issuance date of these financial statements. Accordingly, there are no conditions present as of the Mergers, managementissuance date of these financial statements that raise substantial doubt about our ability to continue as a going concern. Our liquidity could be adversely affected by a material deterioration of future operating results.
Reclassifications
We have reclassified certain prior period amounts for comparative purposes. These reclassifications did not have a material effect on our financial condition, results of operations or cash flows.
Gross profit, as previously presented for the three months ended March 31, 2018, excluded amortization of certain intangible assets. For the three months ended March 31, 2018, $3.1 million of such amortization expense should have been included in cost of sales. The Company has determined that Cyberonicsthis misclassification error was considerednot material to beany prior annual or interim periods. For comparability among periods, the accounting acquirer and predecessor for accounting purposes.
Reclassification of Prior-Year Comparative Period Presentation
To conform the condensedCompany no longer presents gross profit within its consolidated statementstatements of income (loss) for the three and nine months ended September 30, 2016, to the current period presentation, we reclassified $0.7 million and $2.2 million, respectively, of Litigation Related Expenses to the Product Remediation line, and $1.7 million and $2.5 million, respectively, of Litigation Related Expenses to Selling, General and Administrative Expenses.
To conform the condensed consolidated balance sheet as of December 31, 2016 to the current period presentation, we reclassified $4.5 million of Assets Held for Sale, relating to our plan to exit the Costa Rica manufacturing operation, to a separate line item in the condensed consolidated balance sheet from Prepaid Expenses and Other Current Assets. We received $4.9 million in proceeds from the sale of our Costa Rica manufacturing operation during the nine months ended September 30, 2017.
To conform the condensed consolidated statement of cash flows for the nine months ended September 30, 2016 to the current period presentation, certain amounts were reclassified within Operating Activities. Commencing with nine months ended September 30, 2017, Loans to Equity and Cost Method Investees of 6.9 million were presented as Investing Activities. To conform the condensed consolidated statement of cash flows for the nine months ended September 30, 2016 to the current period presentation, Loans to Equity and Cost Method Investees of $6.6 million were reclassified from Financing Activities to Investing Activities.all periods.
Significant Accounting Policies
Our significant accounting policies are detailed in "Note 2:2. Basis of Presentation, Use of Accounting Estimates and Significant Accounting Policies" and “Note 3. Revenue Recognition” of our 20162018 Form 10-K. A further explanationChanges to our accounting policies as a result of our Foreign Currencyadopting the new lease accounting policy isstandard are discussed below:below.
Foreign Currency
Our functional currency isOn January 1, 2019, we adopted ASC Update (“ASU”) No 2016-02, Leases, including subsequent related accounting updates (collectively referred to as “Topic 842”), which supersedes the U.S. dollar, however, a portion ofprevious accounting model for leases. We adopted the revenues earned and expenses incurred by certain of our subsidiaries are denominated in currencies other than the U.S. dollar. We determine the functional currency of our subsidiaries that exist and operate in different economic and currency environments based on the primary economic environment in which the subsidiary operates, that is, the currency of the environment in which an entity primarily generates and expends cash. Our significant foreign subsidiaries are located in Europe and the U.S. The functional currency of our significant European subsidiaries is the Euro and the functional currency of our significant U.S. subsidiaries is the U.S. dollar.standard



using the modified retrospective approach with an effective date as of January 1, 2019. Prior year financial statements were not recast under the new standard. In addition, we elected the package of practical expedients permitted under the transition guidance within the new standard, which among other things, allowed us to carry forward our historical assessment of whether contracts are or contain leases and lease classification. We also elected the practical expedient to account for lease and non-lease components together as a single combined lease component, which is applicable to all asset classes. We did not, however, elect the practical expedient related to using hindsight in determining the lease term as this was not relevant following our election of the modified retrospective approach.
AssetsIn addition, we elected certain practical expedients on an ongoing basis, including the practical expedient for short-term leases pursuant to which a lessee is permitted to make an accounting policy election by class of underlying asset not to recognize a lease liability and operating lease asset for leases with a term of 12 months or less and that do not include an option to purchase the underlying asset that the lessee is reasonably certain to exercise. We have applied this accounting policy to all asset classes in our portfolio, and will recognize the lease payments for such short-term leases within profit and loss on a straight-line basis over the lease term.
Furthermore, from a lessor perspective, certain of our agreements that allow the customer to use, rather than purchase, our medical devices will meet the criteria of being a lease in accordance with the new standard. While the amount of revenue and expenses recognized over the contract term will not be impacted, the timing of revenue and expense recognition will be impacted depending upon lease classification. We enacted appropriate changes to our business processes, systems and internal controls to support recognition and disclosure under the new standard.
We determine if an arrangement is or contains a lease at inception. Operating lease assets and operating lease liabilities for subsidiaries whose functional currency is not the U.S. dollar are translated into U.S. dollarsrecognized based on a combinationthe present value of both currentthe future minimum lease payments over the lease term at the latter of our lease standard effective date for adoption or the lease commencement date. Variable lease payments, such as common area rent maintenance charges and historical exchange rates, while their revenues earnedrent escalations not known upon lease commencement, are not included in determination of the minimum lease payments and expenses incurred are translated into U.S. dollars at average period exchange rates. Translation adjustments are included as ‘Accumulated other comprehensive income (loss)’ (“AOCI”)will be expensed in the condensed consolidated balance sheets. Gainsperiod in which the obligation for those payments is incurred. As most of our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information available at commencement in determining the present value of future payments. The incremental borrowing rate represents an estimate of the interest rate we would incur at lease commencement to borrow an amount equal to the lease payments on a collateralized basis over the term of a lease within a particular currency environment. We used the incremental borrowing rate available nearest to our adoption date for leases that commenced prior to that date. The operating lease asset also includes any lease payments made in advance and losses arising from transactions denominated inexcludes lease incentives. Our lease terms may include options to extend or terminate the lease when it is reasonably certain that we will exercise that option. Lease expense for minimum lease payments is recognized on a currency different from an entity’s functional currency are included in ‘Foreign exchange and other (losses) gains’ in our condensed consolidated statements of income (loss).straight-line basis over the lease term.
For additional information refer to “Note 10. Leases.”
Note 2. AcquisitionsBusiness Combinations
In supportImThera Medical, Inc.
ImThera manufactures an implantable device for the treatment of our strategic growth initiatives, on May 2, 2017,obstructive sleep apnea that stimulates multiple tongue muscles via the hypoglossal nerve, which opens the airway while a patient is sleeping. ImThera has a commercial presence in the European market, and an FDA pivotal study is ongoing in the U.S.
On January 16, 2018, we acquired the remaining 51% equity interests86% outstanding interest in Caisson Interventional, LLCImThera Medical, Inc. (“Caisson”ImThera”) for a purchase price of up to $72.0 million, net of $6.3 million of debt forgiveness, consisting of $18.0 million paid at closing, $14.4 million to be paid after 12 months, and contingentcash consideration of up to $39.6$225 million. Cash in the amount of $78.3 million was paid at closing with the balance to be paid based on achievement of a schedule driven primarily bycertain regulatory approvalsmilestone and a sales-based earnout.
Caisson, a clinical-stage medical device company based in Maple Grove, Minnesota, is focused on the design, development and clinical evaluation of a novel transcatheter mitral valve replacement (“TMVR”) implant device with a fully transvenous delivery system.
The following table presents the acquisition date fair-valuefair value of the consideration transferred and the fair value of our interest in CaissonImThera prior to the acquisition (in thousands):
Cash (1)
 $15,660
Debt forgiven (2)
 6,309
Deferred consideration (1)
 12,994
Contingent consideration (1)
 29,303
Fair value of consideration transferred 64,266
Fair value of our interest prior to the acquisition (2)
 52,505
Fair value of total consideration $116,771
Cash $78,332
Contingent consideration 112,744
Fair value of our interest in ImThera prior to the acquisition (1)
 25,580
Fair value of consideration transferred $216,656
(1)
Concurrent withThe fair value of our previously-held interest in ImThera was determined based on the acquisition,fair value of total consideration transferred and application of a discount for lack of control. As a result, we recognized $5.8a gain of $11.5 million for the fair value in excess of post-combination compensation expense. Of this amount, $2.4 millionour carrying value of $14.1 million. The gain is reflectedincluded in gain on acquisition on our condensed consolidated statement of income for the three months ended March 31, 2018.


The purchase price allocation for the ImThera acquisition was finalized during the first quarter of 2019 and is presented in the following table, including certain measurement period adjustments (in thousands):
  Initial Purchase Price Allocation 
Measurement Period Adjustments (1)
 Adjusted Purchase Price Allocation
In-process research and development (2)
 $151,605
 $10,677
 $162,282
Developed technology 5,661
 (5,661) 
Goodwill 87,063
 (4,467) 82,596
Deferred tax liabilities, net (3)
 (27,980) (1,278) (29,258)
Other assets and liabilities, net 836
 200
 1,036
Net assets acquired $217,185
 $(529) $216,656
(1)During the second quarter of 2018, measurement period adjustments were recorded based upon new information obtained about facts and circumstances that existed as a reduction of $18.0 million in cash paid at closing of the acquisition while $3.4 million increased the deferred consideration and contingent consideration liabilities recognized at the date of the acquisition to a total of $14.1 million and $31.7 million, respectively.date.
(2)On the acquisition date, we remeasured the notes receivable from Caisson and our existing investment in Caisson atThe fair value of in-process research and recognizeddevelopment ("IPR&D") was determined using the income approach, which is a pre-tax non-cash gainvaluation technique that provides a fair value estimate based on the market participant expectations of $1.3 millioncash flows the asset would generate. The cash flows were discounted commensurate with the level of risk associated with the asset. The discount rates were developed after assigning a probability of success to achieving the projected cash flows based on the current stage of development, inherent uncertainty in reaching certain regulatory milestones and $38.1 million, respectively, which arerisks associated with commercialization of the product. The IPR&D amount is included in ‘Gainintangible assets, net on acquisition of Caisson Interventional, LLC’ in the condensed consolidated statementsbalance sheets at March 31, 2019 and December 31, 2018.
(3)The amounts are presented net of income (loss).deferred tax assets acquired.
The following table presentsGoodwill arising from the preliminary purchase price allocation at fair value for the CaissonImThera acquisition, (in thousands):
Cash and cash equivalents $1,468
In-process research and development 89,000
Goodwill 42,417
Other assets 918
Current liabilities 1,023
Deferred income tax liabilities, net 16,009
Net assets acquired $116,771
Acquired goodwill of $9.6 millionwhich is expected to benot deductible for tax purposes. Additionally, $3.0 millionpurposes, primarily represents the synergies anticipated between ImThera and our existing neuromodulation business. The assets acquired, including goodwill, are recognized in our Neuromodulation segment.
The results of the initial cash payment was depositedImThera acquisition added $0.1 million in escrow for future claims indemnification. Of this amount, $2.0 million is included in ‘Prepaid expensesrevenue and other current assets’ and the remaining $1.0 million is included in ‘Other long-term assets’ onoperating losses during the condensed consolidated balance sheet as of September 30, 2017.
Wethree months ended March 31, 2018. Additionally, we recognized ImThera acquisition-related expenses of approximately $1.0$0.2 million for legal and valuation expenses during the ninethree months ended September 30, 2017.March 31, 2018. These expenses are included within ‘Selling,“Selling, general and administrative’administrative” expenses in the condensed consolidated statements of income (loss). Additionally, the results of Caisson for the period of May 2, 2017 through September 30, 2017 added no revenue and $16.9 million in expenses in our condensed consolidated statement of income (loss).


income. Pro forma financial information assuming the ImThera acquisition had occurred as of the beginning of the calendar year prior to the year of acquisition was not material for disclosure purposes.
The ImThera business combination involved contingent consideration arrangements are composed of potential cash payments upon the achievement of a certain regulatory milestonesmilestone and a sales-based earnout associated with sales of products covered by the purchase agreement. The sales-based earnout was valued using projected sales from our internal strategic plans.plan. Both arrangements are Level 3 fair value measurements and include the following significant unobservable inputs (in thousands):
Caisson Acquisition Fair value at May 2, 2017 Valuation Technique Unobservable Input Ranges
Regulatory milestone-based payments $14,883
 Discounted cash flow Discount rate 2.6% - 3.4%
      Probability of payment 90-95%
      Projected payment years 2018-2023
         
Sales-based earnout 16,805
 Monte Carlo simulation Discount rate 11.5-12.7%
      Sales volatility 36.9%
      Projected years of sales 2019-2033
  $31,688
      
ImThera Acquisition Fair value at January 16, 2018 Valuation Technique Unobservable Input Ranges
Regulatory milestone-based payment $50,429
 Discounted cash flow Discount rate 4.3% - 4.7%
      Probability of payment 85% - 95%
      Projected payment years 2020 - 2021
         
Sales-based earnout 62,315
 Monte Carlo simulation Risk-adjusted discount rate 11.5%
      Credit risk discount rate 4.7% - 5.8%
      Revenue volatility 29.3%
      Probability of payment 85% - 95%
  
   Projected years of earnout 2020 - 2025
  $112,744
      
The following table providesFor a reconciliation of the beginning and ending balance of the contingent consideration liability, which consistedrefer to “Note 7. Fair Value Measurements.”


TandemLife
TandemLife is focused on the delivery of arrangements that arose fromleading-edge temporary life support systems, including cardiopulmonary and respiratory support solutions. TandemLife complements our Cardiovascular portfolio, and expands our existing line of cardiopulmonary products.
On April 4, 2018, we acquired CardiacAssist, Inc., doing business as TandemLife (“TandemLife”) for cash consideration of up to $254 million. Cash of $204 million was paid at closing with up to $50 million in contingent consideration based on achieving regulatory milestones.
The following table presents the Caisson acquisition and other previous acquisitions that also included contingentdate fair value of the consideration transferred (in thousands):
Balance at December 31, 2016 $3,890
Purchase price - Caisson contingent consideration 31,688
Payments (1,841)
Changes in fair value 231
Effect of changes in foreign currency exchange rates 249
Balance at September 30, 2017 (1)
 $34,217
Cash $203,671
Contingent consideration 40,190
Fair value of consideration transferred $243,861
The following table presents the preliminary purchase price allocation at fair value for the TandemLife acquisition (in thousands):
  Initial Purchase Price Allocation 
Measurement Period Adjustments (1)
 Adjusted Purchase Price Allocation
In-process research and development (2) (3)
 $110,977
 $(3,474) $107,503
Trade names (2)
 11,539
 
 11,539
Developed technology (2)
 6,387
 
 6,387
Goodwill 118,917
 (797) 118,120
Inventory 10,296
 (140) 10,156
Other assets and liabilities, net 3,632
 242
 3,874
Deferred tax liabilities, net (17,887) 4,169
 (13,718)
Net assets acquired $243,861
 $
 $243,861
(1)The contingent consideration liability represents contingent paymentsDuring the third quarter of 2018, measurement period adjustments were recorded based upon new information regarding future estimates of R&D expenses that existed as of the acquisition date. In addition, during the first quarter of 2019, measurement period adjustments related to three acquisitions:finalizing our tax attributes were recorded, which resulted in an increase of $3.3 million in deferred tax assets and a commensurate decrease to goodwill.
(2)The amounts are included in intangible assets, net in the firstcondensed consolidated balance sheets at March 31, 2019 and second acquisitions, in September 2015, were Cellplex PTY Ltd. in AustraliaDecember 31, 2018. Trade names and developed technology are amortized over remaining useful lives of 15 and 2 years, respectively.
(3)The fair value of IPR&D was determined using the commercial activities ofincome approach, which is a local distributor in Colombia. The contingent payments for the first acquisition arevaluation technique that provides a fair value estimate based on achievementthe market participant expectations of sales targets bycash flows the acquiree through June 30, 2018 andasset would generate. The cash flows were discounted commensurate with the contingent payments forlevel of risk associated with the second acquisition areasset. The discount rates were developed after assigning a probability of success to achieving the projected cash flows based on salesthe current stage of cardiopulmonary disposable productsdevelopment, inherent uncertainty in reaching certain regulatory milestones and heart lung machinesrisks associated with commercialization of the acquiree through December 2019. The third acquisition, Caisson, occurred in May 2017 and is discussed above. Refer to “Note 6. Fair Value Measurements.”product.
Goodwill arising from the TandemLife acquisition, which is not deductible for tax purposes, primarily represents the synergies anticipated between TandemLife and our existing cardiovascular business. The assets acquired, including goodwill, are recognized in our Cardiovascular segment. Pro forma financial information assuming the TandemLife acquisition had occurred as of the beginning of the calendar year prior to the year of acquisition was not material for disclosure purposes.
The TandemLife business combination involved a contingent consideration arrangement composed of potential cash payments upon the achievement of certain regulatory milestones. The arrangement is a Level 3 fair value measurement and includes the following significant unobservable inputs (in thousands):
TandemLife Acquisition Fair value at April 4, 2018 Valuation Technique Unobservable Input Ranges
Regulatory milestone-based payments $40,190
 Discounted cash flow Discount rate 4.2% - 4.8%
      Probability of payments 75% - 95%
      Projected payment years 2019 - 2020


For a reconciliation of the beginning and ending balance of the contingent consideration refer to “Note 7. Fair Value Measurements.”
Note 3. Discontinued Operations
In November 2017, we concluded that the sale of our Cardiac Rhythm Management (“CRM”) business franchise represented a strategic shift in our business that would have a major effect on future operations and financial results. Accordingly, the operating results of CRM are classified as discontinued operations on our condensed consolidated statements of income (loss) for all the periods presented in this Quarterly Report on Form 10-Q.
We completed the CRM Sale on April 30, 2018 to MicroPort Cardiac Rhythm B.V. and MicroPort Scientific Corporation for total cash proceeds of $195.9 million, less cash transferred of $9.2 million, subject to a closing working capital adjustment. In conjunction with the sale, we entered into transition services agreements to provide certain support services generally for up to twelve months from the closing date of the sale. The services include, among others, accounting, information technology, human resources, quality assurance, regulatory affairs, supply chain, clinical affairs and customer support. During three months ended March 31, 2019, we recognized income of $0.6 million for providing these services. Income recognized related to the transition services agreements is recorded as a reduction to the related expenses in the associated expense line items in the condensed consolidated statements of income (loss).
The following table represents the financial results of CRM presented as net loss from discontinued operations in the condensed consolidated statements of income (loss):
 Three Months Ended March 31, 2018
Net sales$60,107
Costs and expenses: 
Cost of sales22,138
Selling, general and administrative expenses31,826
Research and development11,281
Restructuring expenses651
Revaluation gain on assets and liabilities held for sale(1,213)
Operating loss from discontinued operations(4,576)
Foreign exchange and other gains79
Loss from discontinued operations, before tax(4,497)
Income tax benefit(1,159)
Losses from equity method investments(1,211)
Net loss from discontinued operations$(4,549)
Cash flows attributable to our discontinued operations are included in our condensed consolidated statements of cash flows. For the three months ended March 31, 2018, CRM’s capital expenditures were $0.9 million and stock-based compensation expense was $2.0 million.
Note 3.4. Restructuring
Our 2015 and 2016 Reorganization Plans (the “Plans”) were initiated October 2015 and March 2016, respectively, in conjunction with the completion of the Mergers. We initiated theseinitiate restructuring plans to leverage economies of scale, streamline distribution and logistics and strengthen operational and administrative effectiveness in order to reduce overall costs. Costs associated with these plans were reported as ‘Restructuring expenses’restructuring expenses in ourthe operating results in theof our condensed consolidated statements of income (loss).
Our 2015 and 2016 Reorganization Plans (the “Prior Plans”) were initiated October 2015 and March 2016, respectively, in conjunction with the completion of the merger of Cyberonics, Inc. and Sorin S.p.A. in October 2015. The Prior Plans include the closure of the R&D facility in Meylan, France and consolidation of its R&D capabilities into the Clamart, France facility. We completed the Prior Plans during 2018.
In December 2018, we initiated a reorganization plan (the “2018 Plan”) in order to reduce manufacturing and operational costs associated with our Cardiovascular facilities in Saluggia and Mirandola, Italy and Arvada, Colorado. We estimate that the Plans2018 Plan will result in a net reduction of 326approximately 75 personnel and is expected to be completed by the end of which 292 have occurred as of September 30, 2017.
In March 2017, we committed to a plan to sell our Suzhou Industrial Park facility in Shanghai, China. As a result of this exit plan we recorded an impairment of the building and equipment of $4.6 million and accrued $0.5 million of additional costs, primarily related to employee severance, during the nine months ended September 30, 2017. In addition, the remaining carrying value of the land, building and equipment was reclassified to ‘Assets held for sale’ in March 2017, with a balance of $14.1 million as of September 30, 2017, on the condensed consolidated balance sheet.


2019.
The following table presents restructuring expense accrual detailthe accruals, inventory obsolescence and other reserves, recorded in connection with our reorganization plans (in thousands):


  Employee Severance and Other Termination Costs Other Total
Balance at December 31, 2016 $21,092
 $3,056
 $24,148
Charges 7,126
 4,934
 12,060
Cash payments and adjustments (23,804) (5,480) (29,284)
Balance at September 30, 2017 $4,414
 $2,510
 $6,924
  Employee Severance and Other Termination Costs Other Total
Balance at December 31, 2018 $10,195
 $3,069
 $13,264
Charges 2,480
 53
 2,533
Cash payments and other (7,289) (2,945) (10,234)
Balance at March 31, 2019 $5,386
 $177
 $5,563
The following table presents restructuring expense by reportable segment (in thousands):
 Three Months Ended September 30, Nine Months Ended September 30, Three Months Ended March 31,
 2017 2016 2017 2016 2019 2018
Cardiac Surgery $441
 $916
 $6,944
 $5,878
Cardiac Rhythm Management (391) 571
 (1,750) 16,592
Cardiovascular $422
 $1,341
Neuromodulation 14
 2,882
 513
 7,017
 432
 6
Other 728
 12
 6,353
 7,732
 1,679
 534
Total $792
 $4,381
 $12,060
 $37,219
 $2,533
 $1,881
Note 4.5. Product Remediation Liability
On December 29, 2015, we received an FDA Warning Letter (the “Warning Letter”) alleging certain violations of FDA regulations applicable to medical device manufacturing at our Munich, Germany and Arvada, Colorado facilities. On October 13, 2016, the CDC and FDA separately released safety notifications regarding 3T Heater-Cooler devices in response to which we issued a Field Safety Notice Update for U.S. users of our 3T Heater-Cooler devices to proactively and voluntarily contact facilities to facilitate implementation of the CDC and FDA recommendations.
At December 31, 2016, we recognized a liability for a product remediation plan related to our 3T Heater-Cooler device (“3T device”). The remediation plan we developed consists primarily of a modification of the 3T device design to include internal sealing and the addition of a vacuum system to new and existing devices. These changes are intended to address regulatory actions and to reduce further the risk of possible dispersion of aerosols from 3T devices in the operating room. We concluded that it was probable that a liability had been incurred upon management’s approval of the plan and the commitments made by management to various regulatory authorities globally in November and December 2016, and furthermore, the cost associated with the plan was reasonably estimable. The deployment of this solution for commercially distributed devices has been dependent upon final validation and verification of the design changes and approval or clearance by regulatory authorities worldwide, including FDA clearance in the U.S. It is reasonably possible that our estimate of the remediation liability could materially change in future periods due to the various significant assumptions involved such as customer behavior, market reaction and the timing of approvals or clearance by regulatory authorities worldwide.
In April 2017, we obtained CE Mark in Europe for the design change of the 3T device, and in May 2017 we completed our first vacuum canister and internal sealing upgrade on a customer-owned device. We are currently implementing the vacuum canister and internal sealing upgrade program in as many countries as possible throughoutuntil all devices are upgraded. On October 11, 2018, after review of information provided by us, the remainder of 2017. FDA concluded that we could commence the vacuum canister and internal sealing upgrade program in the U.S.
As part of the remediation plan, we also intendcontinue to performoffer a no-charge deep disinfection service (deep cleaning service) for 3T device users who have reported confirmed M. chimaera mycobacterium contamination. Although the deep disinfection service is not yet available in the U.S., it is currently offered in many countries around the world and will be expanded to additional geographies as we receive the required regulatory approvals. Finally,On April 12, 2018, the FDA agreed to allow us to move forward with the deep cleaning service in the U.S., adding to the growing list of countries around the world in which we offer this service. Also, we are continuing to offer the loaner program for 3T devices, initiated in the fourth quarter of 2016, to provide existing 3T device users with a new loaner 3T device at no charge pending regulatory approval and implementation of the vacuum system addition and deep disinfection service worldwide. This loaner program began in the U.S. and is being made available progressively on a global basis, prioritizing and allocating devices to 3T device users based on pre-established criteria.


Changes in the carrying amount of the product remediation liability are as follows (in thousands):
Balance at December 31, 2016 $33,487
Balance at December 31, 2018 $14,745
Adjustments (15) 589
Remediation activity (5,672) (3,582)
Effect of changes in foreign currency exchange rates 2,446
 (231)
Balance at September 30, 2017 (1)
 $30,246
Balance at March 31, 2019 (1)
 $11,521
(1)
At September 30, 2017,March 31, 2019, the product remediation liability balance is heldincluded within ‘Accruedaccrued liabilities and other’ and ‘Other long-term liabilities’other on the condensed consolidated balance sheet. Refer to “Note 15. Supplemental Financial Information.”
It is reasonably possible thatWe recognized product remediation expenses during the three months ended March 31, 2019, of $2.9 million and $3.7 million during the three months ended March 31, 2018. Product remediation expenses include internal labor costs, costs to remediate certain inspectional observations made by the FDA at our estimateMunich facility and costs associated with the incorporation of the modification of the 3T device design into the next generation 3T device. These costs and related legal costs are expensed as incurred and are not included within the product remediation liability could materially change in future periods due topresented above. During the various significant assumptions involved, such as customer behavior, market reaction and the timingfourth quarter of approvals or clearance by regulatory authorities worldwide. We recognize changes in estimates on2018, we recognizedprospective basis. At this stage, no$294.1 million liability has


been recognized with respect to any lawsuits involving us related to the litigation involving the 3T device, whiledevice. Our related legal costs are expensed as incurred. For further information, please refer to “Note 9.11. Commitments and Contingencies - 3T Heater-Cooler Devices.Contingencies.
Note 5.6. Investments
Cost-Method Investments
Our cost-methodThe following table details the carrying value of our investments in equity securities of non-consolidated affiliates without readily determinable fair values for which we do not exert significant influence over the investee. These equity investments are reported at cost minus impairment, if any, plus or minus changes resulting from observable price changes in orderly transactions for the identical or similar investment of the same issuer. These equity investments are included in ‘Investments’ ininvestments on the condensed consolidated balance sheets and consist of our equity positions in the following privately-held companies (in thousands):
 September 30, 2017 December 31, 2016 March 31, 2019 December 31, 2018
Respicardia Inc. (1)
 $21,129
 $17,518
 $17,706
 $17,706
ImThera Medical, Inc. (2)
 12,000
 12,000
Ceribell, Inc. 3,000
 3,000
Rainbow Medical Ltd. (3)
 4,178
 3,733
 1,099
 1,119
MD Start II 1,179
 526
 1,123
 1,144
Other (4)
 150
 
Highlife S.A.S. 1,064
 1,084
Other 770
 770
 $38,636
 $33,777
 $24,762
 $24,823
(1)
Respicardia Inc. (“Respicardia”) is a privately funded U.S. company developing an implantable device designed to restore a more natural breathing pattern during sleep in patients with central sleep apnea ("CSA") by transvenously stimulating the phrenic nerve. We have a loan outstanding to Respicardia, with a carrying amount of $1.5$0.6 millionas of September 30, 2017,March 31, 2019 and December 31, 2018, which is included in ‘Prepaidprepaid expenses and other current assets’ onassets in the condensed consolidated balance sheet.
(2)ImThera Medical Inc. (“ImThera”) is a privately funded U.S. company developing a neurostimulation device system for the treatment of obstructive sleep apnea. We have a loan outstanding to ImThera as of September 30, 2017, with a carrying amount of $1.0 million, which is included in ‘Other assets’ on the condensed consolidated balance sheet.
(3)
Rainbow Medical Ltd. is a private Israeli venture capital company that seeds and grows companies developing medical devices in a diverse range of medical fields.
(4)During the nine months ended September 30, 2017, we sold our investment in Istituto Europeo di Oncologia S.R.L, for a gain of $3.2 million. This gain is included in ‘Foreign exchange and other gains (losses)’ in the condensed consolidated statement of income (loss).
Equity Method Investments
Our equity-method investments are included in ‘Investments’ in the condensed consolidated balance sheets and consist of our equity position in the following entities (in thousands, except for percent ownership):
  
% Ownership (1)
 September 30, 2017 December 31, 2016
MicroPort Sorin CRM (Shanghai) Co. Ltd. (2)
 49.0% $6,948
 $4,867
Highlife S.A.S. (3)
 38.0% 779
 6,009
Caisson Interventional LLC (4)
 
 
 16,423
Other   17
 16
Total   $7,744
 $27,315
(1)Ownership percentages as of September 30, 2017.
(2)During the three months ended September 30, 2017 we invested an additional $4.5 million in MicroPort Sorin CRM (Shanghai) Co. Ltd.
(3)Highlife S.A.S is a privately held clinical-stage medical device company located in France and is focused on the development of a unique transcatheter mitral valve replacement system to treat patients with mitral regurgitation. During the three months ended September 30, 2017, we recognized an impairment of our investment in, and notes receivable from, Highlife. See the paragraph below for further details.
(4)On May 2, 2017, we acquired the 51% remaining equity interests in Caisson Interventional LLC (“Caisson”), and we began consolidating the results of Caisson as of the acquisition date. Refer to “Note 2. Acquisitions” and to “Note 6. Fair Value Measurements” for further information.
Highlife Impairment
We recognized an impairment of our equity-method investment in, and notes receivable from, Highlife S.A.S. (“Highlife”) during the nine months ended September 30, 2017. Certain factors, including a revision in our investment strategy, indicated that the carrying value of our aggregate investment might not be recoverable and that the decrease in value of our aggregate investment was other than temporary. We, therefore, estimated the fair value of our investment and notes receivable using the


market approach. The estimated fair value of our aggregate investment was below our carrying value by $13.0 million. This aggregate impairment was included in ‘Losses from equity method investments’ in the condensed consolidated statements of income (loss). The updated carrying value of our notes receivable from Highlife at September 30, 2017 was $0.8 million and is included in ‘Other assets’ on the condensed consolidated balance sheet.
Note 6.7. Fair Value Measurements
We review the fair value hierarchy classification on a quarterly basis. Changes in the ability to observe valuation inputs may result in a reclassification of levels for certain securities within the fair value hierarchy. There were no transfers between Level 1, Level 2, or Level 3 during the three months ended March 31, 2019 and 2018.


Assets and Liabilities Measured at Fair Value on a Recurring Basis
The following table provides information by level for assets and liabilities that are measured at fair value on a recurring basis (in thousands):
  Fair Value
as of
 Fair Value Measurements Using Inputs Considered as:
  September 30, 2017 Level 1 Level 2 Level 3
Liabilities:        
Derivative liabilities - designated as cash flow hedges (foreign currency exchange rate "FX") $724
 $
 $724
 $
Derivative liabilities - designated as cash flow hedges (interest rate swaps) 1,807
 
 1,807
 $
Derivative liabilities - freestanding instruments (FX) 1,456
 
 1,456
 
Contingent consideration 34,217
 
 
 34,217
  $38,204
 $
 $3,987
 $34,217
  Fair Value as of March 31, 2019 Fair Value Measurements Using Inputs Considered as:
   Level 1 Level 2 Level 3
Assets:        
Derivative assets - freestanding instruments (foreign currency exchange rate “FX”) $228
 $
 $228
 $
  $228
 $
 $228
 $
         
Liabilities:        
Derivative liabilities - designated as cash flow hedges FX $1,082
 $
 $1,082
 $
Derivative liabilities - designated as cash flow hedges (interest rate swaps) 738
 
 738
 
Derivative liabilities - freestanding instruments FX 198
 
 198
 
Contingent consideration (1)
 189,382
 
 
 189,382
  $191,400
 $
 $2,018
 $189,382
 Fair Value
as of
 Fair Value Measurements Using Inputs Considered as: Fair Value as of December 31, 2018 Fair Value Measurements Using Inputs Considered as:
 December 31, 2016 Level 1 Level 2 Level 3  Level 1 Level 2 Level 3
Assets:                
Derivative assets - designated as cash flow hedges (FX) $4,911
 $
 $4,911
 $
Derivative assets - freestanding instruments (FX) 3,358
 
 3,358
 
Derivative assets - freestanding instruments (foreign currency exchange rate "FX") $236
 $
 $236
 $
 $8,269
 $
 $8,269
 $
 $236
 $
 $236
 $
                
Liabilities:                
Derivative liabilities - designated as cash flow hedges (FX) $942
 $
 $942
 $
 $1,354
 $
 $1,354
 $
Derivative liabilities - designated as cash flow hedges (interest rate swaps) 1,392
 
 1,392
 
 865
 
 865
 
Derivative liabilities - freestanding instruments (FX) 3,173
 
 3,173
 
Contingent consideration(1) 3,890
 
 
 3,890
 179,911
 
 
 179,911

 $6,224
 $
 $2,334
 $3,890
 $185,303
 $
 $5,392
 $179,911
(1)The contingent consideration liability represents contingent payments related to four completed acquisitions: Inversiones Drilltex SAS (“Drillex”), Caisson, ImThera and TandemLife. See the table below for additional information.
Our recurring fair value measurements, using significant unobservable inputs (level(Level 3), relate solely to our contingent consideration liability. Refer to “Note 2. Acquisitions” forThe following table provides a discussionreconciliation of the changes inbeginning and ending balance of the fair value of our contingent consideration liability.liability (in thousands):
Total contingent consideration liability at December 31, 2018 $179,911
Changes in fair value (1)
 9,457
Effect of changes in foreign currency exchange rates 14
Total contingent consideration liability at March 31, 2019 189,382
Less current portion of contingent consideration liability at March 31, 2019 42,302
Long-term portion of contingent consideration liability at March 31, 2019 $147,080


(1)The change in fair value was primarily due to the impact of decreases in interest rates subsequent to December 31, 2018, which directly impacts the discount rate utilized in the valuation of contingent consideration.
Note 7.8. Financing Arrangements
The outstanding principal amount of long-term debt (in thousands, except interest rates):
 September 30, 2017 December 31, 2016 Maturity Interest Rate March 31, 2019 December 31, 2018 Maturity Interest Rate
European Investment Bank (1)
 $78,590
 $78,987
 June 2021 0.95%
2017 European Investment Bank (1)
 $103,570
 $103,570
 June 2026 3.59%
2014 European Investment Bank (2)
 46,745
 47,606
 June 2021 0.97%
Mediocredito Italiano (3)
 7,719
 7,276
 December 2023 0.50% - 3.07%
 7,502
 7,623
 December 2023 0.50% - 3.02%
Banca del Mezzogiorno (2)
 6,490
 6,747
 December 2019 0.50% - 3.15%
Bpifrance (ex-Oséo) 1,603
 1,909
 October 2019 2.58%
Bank of America, U.S. 2,973
 
 January 2021 4.51%
Banca del Mezzogiorno (4)
 2,678
 2,718
 December 2019 0.50% - 3.07%
Region Wallonne 831
 798
 December 2023 and June 2033 0.00% - 2.45%
 719
 742
 December 2023 and June 2033 0.75% - 1.24%
Mediocredito Italiano - mortgages and other 742
 799
 September 2021 and September 2026 0.40% - 0.65%
 543
 582
 September 2021 and September 2026 0.77% - 1.27%
Total debt 95,975
 96,516
  
Total long-term facilities 164,730
 162,841
  
Less current portion of long-term debt 24,122
 21,301
   22,880
 23,303
  
Total long-term debt $71,853
 $75,215
   $141,850
 $139,538
  
(1)The 2017 European Investment Bank (“2017 EIB”) loan was obtained to support certain product development projects. The interest rate for the 2017 EIB loan is reset by the lender each principal payment date based on LIBOR. Interest payments are paid quarterly and principal payments are paid semi-annually.
(2)The 2014 European Investment Bank (“2014 EIB”) loan was obtained in July 2014 to support certain product development projects. The interest rate for the 2014 EIB loan is reset by the lender each quarter based on the Euribor. Interest payments are paid quarterly and principal payments are paid semi-annually.
(2)The Banca del Mezzogiorno loan was obtained in January 2015 to support R&D projects as a part of the Large Strategic Project program of the Italian Ministry of Education.
(3)We obtained the Mediocredito Italiano Bank loan in July 2016 as part of the Fondo Innovazione Teconologica program implemented by the Italian Ministry of Education.
(4)The Banca del Mezzogiorno loan was obtained in January 2015 to support R&D projects as a part of the Large Strategic Project program of the Italian Ministry of Education.
On March 26, 2019, we entered into a Facility Agreement with Bank of America Merrill Lynch International DAC, Barclays Bank PLC, BNP Paribas (London Branch) and Intesa Sanpaolo S.P.A. that provides a multicurrency term loan facility in an aggregate amount of $350 million and terminates on March 26, 2022. As of March 31, 2019, there have been no borrowings drawn under the facility. Future borrowings under the facility will bear interest at a rate of LIBOR plus 1.6% for borrowings in U.S. dollars and EURIBOR plus 1.4% for euro-denominated borrowings. The proceeds of the facility are intended to be used towards general corporate and working capital purposes, excluding acquisitions, dividends and share buybacks. The facility became available on March 26, 2019, subject to satisfaction of certain customary conditions precedent including payment of certain upfront fees and evidence of cancellation and repayment in full of our $70.0 million revolving credit facility from Barclays Bank PLC on or before the first utilization date. The Facility Agreement contains financial covenants that require LivaNova to maintain a maximum consolidated net debt to EBITDA ratio, a minimum interest coverage ratio and a maximum consolidated net debt to net worth ratio. LivaNova must also maintain a minimum amount of consolidated net worth. The Facility Agreement also contains customary representations and warranties, covenants, and events of default.
Revolving Credit
The outstanding principal amount of our short-term unsecured revolving credit agreements and other agreements with various banks was $28.0$16.6 million and $26.4$5.5 million, at September 30, 2017March 31, 2019 and December 31, 2016,2018, respectively, with interest rates ranging from 0.2% to 10.5%9.1% and loan terms ranging from one day30 days to 365 days.
European Investment Bank Financing Agreement
On June 29, 2017, we entered into a new finance contract (the “Finance Contract”) with the EIB to support financing of certain R&D projects. The Finance Contract has a borrowing base of €100 million (or approximately $118 million USD equivalent) and can be drawn in up to two tranches, each in a minimum amount of €50 million (or approximately $59 million USD equivalent). Drawdowns must occur by December 30, 2018, and the last repayment date of any tranche will be no earlier than four years and no later than eight years after the disbursement of the relevant tranche. Loans under the Finance Contract are subject to certain covenants and other terms and conditions. No loan drawdowns have occurred180 days as of September 30, 2017.March 31, 2019.
Note 8.9. Derivatives and Risk Management
Due to the global nature of our operations, we are exposed to foreign currency exchange rate fluctuations. In addition, due to certain loans with floating interest rates, we are also subject to the impact of changes in interest rates on our interest payments. We enter into foreign currency exchange rate (“FX”) derivative contracts and interest rate swap contracts to reduce the impact of foreign currency exchange rate and interest rate fluctuations on earnings and cash flow. We measure all outstanding derivatives each period end at fair value and report the fair value as either financial assets or liabilities inon the condensed


consolidated balance sheets. We do not enter into derivative contracts for speculative purposes. At inception of the contract, the derivative is designated as either a freestanding derivative or a hedge. Derivatives that are not designated as hedging instruments are referred to as freestanding derivatives with changes in fair value included in earnings.
If the derivative qualifies for hedge accounting, depending on the nature of the hedge and hedge effectiveness, changes in the fair value of the derivative will either be recognized immediately in earnings or recorded in accumulated other AOCIcomprehensive income (“AOCI”) until the hedged item is recognized in earnings upon settlement/termination. FX derivative gains and losses in AOCI are reclassified to theour condensed consolidated statementstatements of income (loss) as shown in the tables below and interest rate swap gains and losses in AOCI are reclassified to interest expense in theon our condensed consolidated statementstatements of income (loss). We evaluate hedge effectiveness at inception and on an ongoing basis. If a derivative is no longer expected to be highly effective hedge accounting is discontinued. Hedge ineffectiveness, if


any, is recorded indiscontinued and the gains or losses are reclassified into earnings. Cash flows from derivative contracts are reported as operating activities in theon our condensed consolidated statements of cash flows.
Freestanding FX Derivative FX Contracts
The gross notional amount of freestanding derivativesFX derivative contracts, not designated as hedging instruments, outstanding at September 30, 2017March 31, 2019 and December 31, 20162018 was $239.0$185.1 million and $489.1$320.2 million, respectively. These derivative contracts are designed to offset the FX effects in earnings of various intercompany loans, our 2014 EIB loan, and trade receivables. We recorded net lossesgains for these freestanding derivatives of $0.7 million and $7.9$3.7 million for the three and nine months ended September 30, 2017, respectively,March 31, 2019 and net gains (losses)losses of $(1.8) million and $0.4$7.6 million for the three and nine months ended September 30, 2016, respectively.March 31, 2018. These gains and losses are included in ‘Foreignforeign exchange and other gains (losses)’ in the on our condensed consolidated statements of income (loss).
Cash Flow Hedges
Notional amounts of open derivative contracts designated as cash flow hedges (in thousands):
Description of Contract September 30, 2017 December 31, 2016
Description of Derivative Contract March 31, 2019 December 31, 2018
FX derivative contracts to be exchanged for British Pounds $16,928
 $6,663
 $7,176
 $9,629
FX derivative contracts to be exchanged for Japanese Yen 44,618
 57,840
 21,932
 23,985
FX derivative contracts to be exchanged for Canadian Dollars 13,341
 
 5,301
 7,637
FX derivative contracts to be exchanged for Euros 19,574
 29,768
Interest rate swap contracts 62,917
 63,246
 37,422
 38,115
 $137,804
 $127,749
 $91,405
 $109,134
After-tax net loss associated with derivatives designated as cash flow hedges recorded in the ending balance of AOCI and the amount expected to be reclassified to earnings in the next 12twelve months (in thousands):
Description of Contract September 30, 2017 Net Amount Expected to be Reclassified to Earnings in the Next 12 Months
Description of Derivative Contract After-tax net loss in AOCI as of March 31, 2019 Amount Expected to be Reclassified to Earnings in Next 12 Months
FX derivative contracts $(287) $(287) $(805) $(805)
Interest rate swap contracts (261) (69) (147) (66)
 $(548) $(356) $(952) $(871)


Pre-tax gains (losses) for derivative contracts designated as cash flow hedges recognized in Other Comprehensive (Loss) Income (Loss) (“OCI”) and the amount reclassified to earnings from AOCI (in thousands):
    Three Months Ended September 30,
    2017 2016
Description of Contract Location in Earnings of Reclassified Gain or Loss Losses Recognized in OCI (Losses) Gains Reclassified from AOCI to Earnings (Losses) Gains Recognized in OCI Losses Reclassified from AOCI to Earnings
FX derivative contracts Foreign exchange and other (losses) gains $(2,537) $(1,623) $2,535
 $2,795
FX derivative contracts SG&A 
 269
 
 (1,876)
Interest rate swap contracts Interest expense 
 797
 263
 (163)
    $(2,537) $(557) $2,798
 $756


 Nine Months Ended September 30, Three Months Ended March 31,
 2017 2016 2019 2018
Description of Contract Location in Earnings of Reclassified Gain or Loss Losses Recognized in OCI (Losses) Gains Reclassified from AOCI to Earnings Losses Recognized in OCI Gains (Losses) Reclassified from AOCI to Earnings
Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss Gains Recognized in OCI Gains (Losses) Reclassified from AOCI to Earnings Gains Recognized in OCI Gains Reclassified from AOCI to Earnings
FX derivative contracts Foreign exchange and other (losses) gains $(10,124) $(6,833) $(5,932) $2,943
 Foreign exchange and other gains $1,309
 $1,642
 $214
 $846
FX derivative contracts SG&A 
 1,623
 
 (3,437) SG&A 
 (310) 
 625
Interest rate swap contracts Interest expense 
 1,009
 (38) (252) Interest expense 
 (13) 
 
 $(10,124) $(4,201) $(5,970) $(746) $1,309
 $1,319
 $214
 $1,471
The following tables present the fair value on a gross basis, and the location of, derivative contracts reported in the condensed consolidated balance sheets (in thousands):
September 30, 2017 Liability Derivatives
March 31, 2019 Asset Derivatives Liability Derivatives
Derivatives Designated as Hedging Instruments Balance Sheet Location 
Fair Value (1)
 Balance Sheet Location 
Fair Value (1)
 Balance Sheet Location 
Fair Value (1)
Interest rate swap contracts Accrued liabilities $875
 Prepaid expenses and other current assets $
 Accrued liabilities $479
Interest rate swap contracts Other long-term liabilities 932
 Other assets 
 Other long-term liabilities 259
FX derivative contracts Accrued liabilities 724
 Prepaid expenses and other current assets 
 Accrued liabilities 1,082
Total derivatives designated as hedging instruments 
 2,531
 
 
 
 1,820
Derivatives Not Designated as Hedging Instruments 
 
 
 
 
 
FX derivative contracts Accrued liabilities 1,456
 Prepaid expenses and other current assets 228
 Accrued liabilities 198
Total derivatives not designated as hedging instruments 
 1,456
 
 228
 
 198
 
 $3,987
Total derivatives 
 $228
 
 $2,018


December 31, 2016 Asset Derivatives Liability Derivatives
December 31, 2018 Asset Derivatives Liability Derivatives
Derivatives Designated as Hedging Instruments Balance Sheet Location 
Fair Value (1)
 Balance Sheet Location 
Fair Value (1)
 Balance Sheet Location 
Fair Value (1)
 Balance Sheet Location 
Fair Value (1)
Interest rate swap contracts Prepaid expenses and other current assets $
 Accrued liabilities $942
 Prepaid expenses and other current assets $
 Accrued liabilities $536
Interest rate swap contracts Other assets 
 Other long-term liabilities 1,392
 Other assets 
 Other long-term liabilities 329
FX derivative contracts Prepaid expenses and other current assets 4,911
 Accrued liabilities 
 Prepaid expenses and other current assets 
 Accrued liabilities 1,354
Total derivatives designated as hedging instruments 4,911
 2,334
 
 2,219
Derivatives Not Designated as Hedging Instruments        
FX derivative contracts Prepaid expenses and other current assets 3,358
 Accrued liabilities 
 Prepaid expenses and other current assets 236
 Accrued liabilities 3,173
Total derivatives not designated as hedging instruments 3,358
 
 236
 3,173
 $8,269
 $2,334
Total derivatives $236
 $5,392
(1)For the classification of inputinputs used to evaluate the fair value of our derivatives, refer to “Note 6.7. Fair Value Measurements.”
Note 10. Leases
We have operating leases primarily for (i) office space, (ii) manufacturing, warehouse and research and development facilities and (iii) vehicles. Our leases have remaining lease terms up to 13 years, some of which include options to extend the leases, and some of which include options to terminate the leases at our sole discretion. The components of operating lease assets, liabilities and costs are as follows (in thousands):
Operating Lease Assets and Liabilities March 31, 2019
Assets  
Operating lease right-of-use assets $57,070
  
Liabilities  
Accrued liabilities and other $10,779
Long-term operating lease liabilities 47,227
Total lease liabilities $58,006
Operating Lease Cost Three Months Ended March 31, 2019
Operating lease cost $3,740
Variable lease cost 171
Short-term lease cost 86
Total lease cost $3,997


Contractual maturities of our lease liabilities as of March 31, 2019, are as follows (in thousands):
2019 $8,790
2020 10,428
2021 8,557
2022 7,499
2023 6,463
Thereafter 22,095
Total lease payments 63,832
Less: Amount representing interest 5,826
Present value of lease liabilities $58,006
Lease Term and Discount RateMarch 31, 2019
Weighted Average Remaining Lease Term7.7
Weighted Average Discount Rate2.3%
Other Information
(in thousands)
 Three Months Ended March 31, 2019
Cash paid for amounts included in the measurement of lease liabilities:  
Operating cash flows for leases $3,842
   
Operating lease assets obtained in exchange for lease liabilities $465
Disclosures Related to Periods Prior to Adoption of Topic 842
On January 1, 2019, we adopted Topic 842 using the modified retrospective adoption approach, as noted in “Note 1. Unaudited Condensed Consolidated Financial Statements.” As required and as previously disclosed in our 2018 Form 10-K, the following table summarizes our future minimum operating lease payments as of December 31, 2018 (in thousands):
Less than one year $11,986
One to three years 21,031
Three to five years 14,998
Thereafter 20,943
Total $68,958
Note 9.11. Commitments and Contingencies
3T Heater-Cooler Devices
FDA Warning Letter.
On December 29, 2015, the FDA issued LivaNova a Warning Letter (the “Warning Letter”) alleging certain violations of FDA regulations applicable to medical device manufacturers at our Munich, Germany and Arvada, Colorado facilities.
The FDA inspected the Munich facility from August 24, 2015 to August 27, 2015 and the Arvada facility from August 24, 2015 to September 1, 2015. On August 27, 2015, the FDA issued a Form 483 identifying two observed non-conformities with certain regulatory requirements at the Munich facility. We did not receive a Form 483 in connection with the FDA’s inspection of the Arvada facility. Following the receipt of the Form 483, we provided written responses to the FDA describing corrective and preventive actions that were underway or to be taken to address the FDA’s observations at the Munich facility. The Warning Letter responded in part to our responses and identified other alleged violations related to the manufacture of our 3T Heater-Cooler device that were not previously included in the Form 483.
The Warning Letter further stated that our 3T devices and other devices we manufactured at our Munich facility are subject to refusal of admission into the U.S. until resolution of the issues set forth by the FDA in the Warning Letter. The FDA has informed us that the import alert is limited to the 3T devices, but that the agency reserves the right to expand the scope of the


import alert if future circumstances warrant such action. The Warning Letter did not request that existing users cease using the 3T device, and manufacturing and shipment of all of our products other than the 3T device remain unaffected by the import limitation. To help clarify these issues for current customers, we issued an informational Customer Letter in January 2016 and that same month agreed with the FDA on a process for shipping 3T devices to existing U.S. users pursuant to a certificate of medical necessity program.
Finally, the Warning Letter stated that premarket approval applications for Class III devices to which certain Quality System regulation deviations identified in the Warning Letter are reasonably related will not be approved until the violations have been corrected. However,corrected; however, this restriction applies only to the Munich and Arvada facilities, which do not manufacture or design devices subject to Class III premarket approval.
We continue to work diligently to remediate the FDA’s inspectional observations for the Munich facility, as well as the additional issues identified in the Warning Letter. We take these matters seriously and intend to respond timely and fully to the FDA’s requests.
CDC and FDA Safety Communications and Company Field Safety Notice Update
On October 13, 2016, the Centers for Disease ControlCDC and Prevention (“CDC”) andthe FDA separately released safety notifications regarding the 3T devices. The CDC’s Morbidity and Mortality Weekly Report (“MMWR”) and Health Advisory Notice (“HAN”) reported that tests conducted by CDC and its affiliates indicate that there appears to be genetic similarity between both patient and 3T device strains of the non-tuberculous mycobacterium (“NTM”) bacteria M. chimaera isolated in hospitals in Iowa and Pennsylvania. Citing the geographic separation between the two hospitals referenced in the investigation, the report asserts that 3T devices manufactured prior to August 18, 2014 could have been contaminated during the manufacturing process. The CDC’s HAN and FDA’s Safety Communication, issued contemporaneously with the MMWR report, each assess certain risks associated with 3T devices and provide guidance for providers and patients. The CDC notification states that the decision to use the 3T device during a surgical operation is to be taken by the surgeon based on a risk approach and on patient need. Both the CDC’s and FDA’s communications confirm that 3T devices are critical medical devices and enable doctors to perform life-saving cardiac surgery procedures.
Also on October 13, 2016, concurrent with the CDC’s HAN and FDA’s Safety Communication, we issued a Field Safety Notice Update for U.S. users of 3T devices to proactively and voluntarily contact facilities to aid in implementation of the CDC and FDA recommendations. In the fourth quarter of 2016, we initiated a program to provide existing 3T device users with a new loaner 3T device at no charge pending regulatory approval and implementation of additional risk mitigation strategies worldwide.worldwide, including a vacuum canister and internal sealing upgrade program and a deep disinfection service. This loaner program began in the U.S. and is being made available progressively on a global basis, prioritizing and allocating devices to 3T device users based on pre-established criteria. We anticipate that this program will continue until we are able to address customer needs through a broader solution that includes implementation of one or more of the risk mitigation strategies described above. We are currently underimplementing the vacuum and sealing upgrade program in as many countries as possible until all devices are upgraded. On October 11, 2018, after review of information provided by us, the FDA concluded that we could commence the vacuum and sealing upgrade program in the U.S. Furthermore, we continue to offer a no-charge deep disinfection service (deep cleaning service) for 3T device users as we receive the required regulatory approvals. On April 12, 2018, the FDA agreed to allow us to move forward with regulatory agencies.the deep cleaning service in the U.S. adding to the growing list of countries around the world in which we offer this service.
On December 31, 2016, we recognized a liability for our product remediation plan related to our 3T device. We concluded that it was probable that a liability had been incurred upon management’s approval of the plan and the commitments made by management to various regulatory authorities globally in November and December 2016, and furthermore, the cost associated with the plan was reasonably estimable. At September 30, 2017,March 31, 2019, the product remediation liability was $30.2$11.5 million. Refer to “Note 4.5. Product Remediation Liability” for additional information.


Litigation
On February 12, 2016, LivaNova was alerted thatProduct Liability
The Company is currently involved in litigation involving our 3T device. The litigation includes a class action complaint had been filed in the U.S. District Court for the Middle District of Pennsylvania, with respect to our 3T devices. The plaintiffs namedfederal multi-district litigation in the complaint underwent open heart surgeries at WellSpan York HospitalU.S. District Court for the Middle District of Pennsylvania, various U.S. state court cases and Penn State Milton S. Hershey Medical Centercases in 2015,jurisdictions outside the U.S. As of April 30, 2019, we are aware of approximately 210 filed and unfiled claims worldwide, with the complaint alleges that: (i) patients were exposed to a harmful form of bacteria, known as nontuberculous mycobacterium (“NTM”), from our 3T devices; and (ii) we knew or should have known that design or manufacturing defects in 3T devices can lead to NTM bacterial colonization, regardlessmajority of the cleaningclaims in various federal or state courts throughout the United States. The complaints generally seek damages and disinfection procedures used (and recommended by us). other relief based on theories of strict liability, negligence, breach of express and implied warranties, failure to warn, design and manufacturing defect, fraudulent and negligent misrepresentation or concealment, unjust enrichment, and violations of various state consumer protection statutes.


The class of plaintiffsaction, filed in the complaintFebruary 2016, consists of all Pennsylvania residents who underwent open heart surgery at WellSpan York Hospital and Penn State Milton S. Hershey Medical Center between 2011 and 2015 and who currently are asymptomatic for NTM infection.
On October 23, 2017, Members of the U.S. District Court for the Middle District of Pennsylvania issued an order certifying a class with respect to the named plaintiffs. The class action, which is currently against Sorin Group Deutschland GmbH and Sorin Group USA, Inc. seeks: (i)seek declaratory relief findingthat the 3T devices are defective and unsafe for intended uses; (ii)uses, medical monitoring; (iii) general damages;monitoring, damages, and (iv) attorneys’ fees. Other lawsuits related to surgeries in whichOn March 29, 2019, we announced a 3T device allegedly was used have been filed elsewheresettlement framework that provides for a comprehensive resolution of the personal injury cases pending in the multi-district litigation in U.S., federal court, the related class action pending in federal court, as well as certain cases in Canada,state courts across the United States. The agreement, which makes no admission of liability, is subject to certain conditions, including acceptance of the settlement by individual claimants and Europe, against various LivaNova entities.
We are defending eachprovides for a total payment of up to $225 million to resolve the claims covered by the settlement, with up to $135 million to be paid no earlier than July 2019 and the remainder in January 2020. However, cases in state courts in the U.S. and in jurisdictions outside the U.S continue to progress. In the fourth quarter of 2018, we recognized a $294.1 million provision, which represents our best estimate of the Company’s liability for these claims vigorously. Givenmatters. At March 31, 2019, the relatively early stageprovision estimate remains unchanged. While the amount accrued represents our best estimate, the actual liability for resolution of these matters we cannot give any assurances that additional legal proceedings makingremains uncertain and may vary from our estimate.
Total coverage under the same or similar allegations willCompany’s product liability insurance policies is $32.9 million, once the self-retention limit of $11.0 million is met. While the Company has not be filed against us or onecurrently recorded a receivable for recovery under the insurance policies as of our subsidiaries, nor thatMarch 31, 2019, the resolution of these complaints or other related litigation will not have a material adverse effect on our business, results of operations, financial condition or liquidity. We have not recognized an expense relatedCompany intends to damagespursue recovery under the policies in connection with these matters because any potential loss is not currently probable or reasonably estimable. In addition we cannot reasonably estimate a rangethe settlement of potential loss, if any, that may result from these matters.the litigation involving our 3T device.
Other LitigationEnvironmental Liability
SNIA Litigation
Our subsidiary, Sorin S.p.A. (“Sorin”) was created as a result of a spin-off (the “Sorin spin-off”) from SNIA S.p.A. (“SNIA”). The Sorin spin-off, which involved SNIA’s medical technology division, in January, 2004. SNIA subsequently became effective on January 2, 2004. Pursuant to the Italian Civil Code, in a spin-off transaction, the parentinsolvent and the spun-off company can be held jointly liable, up to the actual value of the shareholders’ equity conveyed or received, for certain indebtedness or liabilities of the pre-spin-off company. We estimate that the value of the shareholders’ equity received by Sorin was approximately €573 million (approximately $676 million).
We believe and have argued before the relevant fora that Sorin is not jointly liable with SNIA for its alleged SNIA debts and liabilities. Specifically, between 1906 and 2010, SNIA’s subsidiaries Caffaro Chimica S.r.l. and Caffaro S.r.l. and their predecessors (the “SNIA Subsidiaries”), conducted certain chemical operations (the “Caffaro Chemical Operations”), at sites in Torviscosa, Brescia and Colleferro, Italy (the “Caffaro Chemical Sites”). These activities allegedly resulted in substantial and widely dispersed contamination of soil, water and ground water. In connection with SNIA’s Italian insolvency proceedings, the Italian Ministry of the Environment and the Protection of Land and Sea (the “Italian Ministry of the Environment”), sought compensation from SNIA in an aggregate amount of €3.4approximately $4 billion (approximately $4.0 billion) for remediation costs relating to the environmental damage at the Caffaro Chemical Sites.chemical sites previously operated by SNIA’s other subsidiaries.
In September 2011 and July 2014, the Bankruptcy Court of Udine and in July 2014, the Bankruptcy Court of Milan each held (in proceedings to which we are not parties) that the Italian Ministry of the Environment and other Italian government agencies (the “Public Administrations”) were not creditors of either SNIA Subsidiaries or SNIAits subsidiaries in connection with their claims in the context of their Italian insolvency proceedings. InThe Public Administrations appealed and in January 2016, the Court of Udine rejected the appeal brought by the Italian Public Administrations.appeal. The Public Administrations have also appealed that second loss in pending proceedings beforedecision to the Italian Supreme Court. The appeal byIn addition, the Public Administrations before theBankruptcy Court of Milan remains pending.Milan’s decision has been appealed.
In January 2012, SNIA filed a civil action against Sorin in the Civil Court of Milan asserting joint liability of a parent and a spun-off company. SNIA’s civil action against Sorin also named the Public Administrations, the Italian Ministry of the Environment and other Italian government agencies, as defendants, in order to have them bound to the final ruling.
On April 1, 2016, the Court of Milan dismissed all legal actions of SNIA and of the Public Administrations against Sorin, further requiring the Public Administrations to pay Sorin €300,000 (or approximately $353,910), as$328,000 for legal fees (of which SNIA is jointly liable for €50,000) (the “2016 Decision”).
On June 21, 2016, thefees. The Public Administrations appealed the 2016 Decision to the Court of Appeal of Milan. The first hearingOn March 5, 2019, the Court of Appeal issued a partial decision on the merits: the Court has declared Sorin/LivaNova jointly liable with SNIA for SNIA’s environmental liabilities in an amount up to the fair value of the appeal proceedings was held in December 2016,net worth received by Sorin because of the Sorin spin-off. Additionally the Court issued a separate order, staying the proceeding until a Panel of three experts is appointed to identify the environmental damages and the final hearing is now scheduledcosts that the Public Administrations already has borne for November 22, 2017. After the hearing,clean-up of the parties will file their final briefs, andSites to allow the Court is expected to render its decision in mid-2018. SNIA did not file an appeal.


We (as successor to Sorin indecide on the litigation) continue to believe thatsecond claim of the risk of material loss relating toPublic Administrations, for a refund for the SNIA litigation is not probable as a result of the reasoning contained in, and legal conclusions reached in, the recent court decisions described above. We also believe that the amount of potential losses relating to the SNIA litigation is, in any event, not estimable given that the underlying alleged damages, related remediation costs, allocation and apportionment of any such responsibility, which party is responsible, and various time periods involving different parties, all remain issues in dispute and that no final decision on a remediation plan has been approved. As a result, we have not made any accrual in connection with the SNIA litigation.environmental liabilities.
Pursuant to European Union (“EU”), United Kingdom (“UK”) and Italian cross-border merger regulations applicable to the Mergers, legacy Sorin liabilities, including any potential liabilities arising from the claims against Sorin relating to the SNIA litigation, are assumed by us as successor to Sorin. Although we believe the claims against Sorin in connection with the SNIA litigation are without merit and continue to contest them vigorously, there can be no assurance as to the outcome. A finding during any appeal or novel proceedings that we are liable for environmental damage at the Caffaro Chemical Sites or its alleged cause(s) could have a material adverse effect on our results of operations, financial condition and/or liquidity.
Environmental Remediation Order
On July 28, 2015, Sorin and other direct and indirect shareholders of SNIA received an administrative order (the “Remediation Order”) from the Italian Ministry of the Environment (the “Ministry”), directing them to promptly commence environmental remediation efforts at the Caffaro Chemical Sites (as described above). We (as successor to Sorin) believe that we should not be liable for damages relating to the Caffaro Chemical Operations pursuant to the Italian statute on which the Remediation Order relies because, inter alia, the statute does not apply to activities occurring prior to 2006, the date on which the statute was enacted. (Sorin was spun off from SNIA in 2004.) Additionally, we believe that Sorin should not be subject to the Remediation Order because Italian environmental regulations only permit such an order to be imposed on an “operator” of a remediation site, and Sorin never operated any activity at any of the industrial sites concerned and, further, was never identified in any legal proceeding as an operator at any of the Caffaro Chemical Sites and could not and in fact did not cause any environmental damage at any of the Caffaro Chemical Sites.
Accordingly, we (as successor to Sorin) alongside other parties, challenged the Remediation Order before the Administrative Court of Lazio in Rome (the “TAR”).
On March 21, 2016 the TAR annulled the Remediation Order based on the fact that (i) the Remediation Order lacks any detailed analysis of the causal link between the alleged damage and our activities, a pre-condition to imposition of the measures proposed in the Remediation Order, (ii) the situation of the Caffaro site does not require urgent safety measures, because no new pollution events have occurred and no additional information or evidence of a situation of contamination exists, and (iii) there was no proper legal basis for the Remediation Order, and in any event, the Ministry failed to verify the legal elements that could have led to a conclusion of legal responsibility of the recipients of the Remediation Order.
The TAR decisions described above have been appealed by the Ministry before the Council of State. No information on the timing of the first hearing of this appeal is presently available. We have not recognized an expense in connection with this matter because any potential loss is not currently probable or reasonably estimable. In addition, we cannot reasonably estimate a range of potential loss, if any, that may result from this matter.
Opposition to Merger Proceedings
On July 28, 2015, the Public Administrations filed an opposition proceeding to the proposed merger between Sorin and Cyberonics (the “Merger”), before the Commercial Courts of Milan askingto the Courtmerger of Sorin and Cyberonics, Inc., the predecessor companies to prohibit the execution of the Merger. In its initial decision on August 20, 2015, theLivaNova. The Court authorized the Mergermerger and the Public Administrations did not appeal thisthat decision. The proceeding then continued as a civil case, with the Public AdministrationAdministrations seeking damages against us.damages. The Commercial Court of Milan delivered a decision in October 2016, fully rejecting the Public Administration’sAdministrations’ request and awarding us €200,000approximately €400,000 (approximately $228,000)$449,000 as of March 31, 2019) in damages for frivolous litigation plus €200,000 (approximately $228,000) inand legal fees. The Public Administrations has appealed this decision to the Court of Appeal of Milan. The final hearing is scheduled on January 17, 2018. TheOn May 15, 2018, the Court of Appeal of Milan confirmed its decision authorizing the merger but annulled the penalty for frivolous litigation and reduced the overall contribution to legal fees to €84,000 (approximately $94,000 as of March 31, 2019) for legal fees. The Public Administrations subsequently filed an appeal with the Supreme Court against the decision of the Court of Appeal of


Milan. The proceedings before the Supreme Court are presently pending, and no decision is likely to make a decisionexpected in mid-June 2018.2019. We have not recognized an expense in connection with this matter because any potential loss is not currently probable or reasonably estimable. In addition, we cannot reasonably estimate a range of potential loss, if any, that may result from this matter.

Patent Litigation

On May 11, 2018, Neuro and Cardiac Technologies LLC (“NCT”), a non-practicing entity, filed a complaint in the United States District Court for the Southern District of Texas asserting that the VNS Therapy System, when used with the SenTiva Model 1000 generator, infringes the claims of U.S. Patent No. 7,076,307 owned by NCT. The complaint requests damages that include a royalty, costs, interest, and attorneys’ fees. On September 13, 2018 and November 12, 2018, we petitioned the Patent Trial and Appeal Board of the U. S. Patent and Trademark Office (the “Patent Office”) for an inter partes review (“IPR”) of the validity of the ‘307 patent. The Patent Office declined to institute the IPR related to the September 13 petition, but the November 12 IPR is still pending. The Court has stayed the litigation pending the outcome of the remaining IPR proceeding. We have not recognized an expense in connection with this matter because any potential loss is not currently probable or reasonably estimable. In addition, we cannot reasonably estimate a range of potential loss, if any, that may result from this matter.
Tax Litigation
In a tax audit report received inon October 30, 2009, the Regional Internal Revenue Office of Lombardy (the “Internal Revenue Office”) informed Sorin Group Italia S.r.l. that, among several issues, it was disallowing in part (for a total of €102.6 million (approximately $121.0 million)$115.2 million as of March 31, 2019), related to tax years 2002 through 2006) a tax-deductible write down of the investment in the U.S. company, Cobe Cardiovascular Inc., which Sorin Group Italia S.r.l. recognized in 2002 and deducted in five equal installments, beginning in 2002. In December 2009, the Internal Revenue Office issued notices of assessment for 2002, 2003 and 2004. The assessments for 2002 and 2003 were automatically voided for lack of merit. In December 2010 and October 2011, the Internal Revenue Office issued notices of assessment for 2005 and 2006, respectively. We challenged all three notices of assessment (for 2004, 2005 and 2006) before the relevant Provincial Tax Courts.
The preliminary challenges filed for 2004, 2005 and 2006 were denied at the first jurisdictional level. We appealed these decisions. The appeal submitted against the first-level decision for 2004 was successful. The Internal Revenue Office appealed this second-level decision to the Italian Supreme Court (Corte di Cassazione) inon February 3, 2017. The Italian Supreme Court’s decision is pending.
The appeals submitted against the first-level decisions for 2005 and 2006 were rejected. We appealed these adverse decisions to the Italian Supreme Court. On November 16, 2018, the Supreme Court wherereturned the matters are still pending.decisions for years 2005 and 2006 to the previous-level Court (Regional Tax Court) due to lack of substance of the motivation given in the 2nd level judgments that were appealed.
In November 2012, the Internal Revenue Office served a notice of assessment for 2007, and in July 2013, served a notice of assessment for 2008. In these matters the Internal Revenue Office claims an increase in taxable income due to a reduction (similar to the previous notices of assessment for 2004, 2005 and 2006) of the losses reported by Sorin Group Italia S.r.l. for the 2002, 2003 and 2004 tax periods, and subsequently utilized in 2007 and 2008. We challenged both notices of assessment. The Provincial Tax Court of Milan has stayed its decision for years 2007 and 2008 pending resolution of the litigation regarding years 2004, 2005, and 2006. The total amount of losses in dispute is €62.6 million (approximately $73.8 million)$70.3 million as of March 31, 2019). We have continuously reassessed our potential exposure in these matters, taking into account the recent, and generally adverse, trend to Italian taxpayers in this type of litigation. Although we believe that our defensive arguments are strong, noting the adverse trend in some of the court decisions, we have recognized a reserve for an uncertain tax position of €17.0€17.3 million (approximately $20.0$19.4 million). as of March 31, 2019.
Other Matters
Additionally, we are the subject of various pending or threatened legal actions and proceedings that arise in the ordinary course of our business. These matters are subject to many uncertainties and outcomes that are not predictable and that may not be known for extended periods of time. Since the outcome of these matters cannot be predicted with certainty, the costs associated with them could have a material adverse effect on our consolidated net income, financial position or liquidity.


Note 10.12. Stockholders’ Equity
Comprehensive incomeThe table below presents the condensed consolidated statement of stockholders’ equity as of and for the three months ended March 31, 2019 and March 31, 2018 (in thousands):
  Ordinary Shares Ordinary Shares - Amount Additional Paid-In Capital Treasury Stock Accumulated Other Comprehensive (Loss) Income Retained Deficit Total Stockholders' Equity
December 31, 2018 49,323
 $76,144
 $1,705,111
 $(1,462) $(24,476) $(251,579) $1,503,738
Stock-based compensation plans 6
 7
 2,006
 141
 
 
 2,154
Net loss 
 
 
 
 
 (14,849) (14,849)
Other comprehensive loss 
 
 
 
 (4,237) 
 (4,237)
March 31, 2019 49,329
 $76,151
 $1,707,117
 $(1,321) $(28,713) $(266,428) $1,486,806
               
December 31, 2017 48,290
 $74,750
 $1,735,048
 $(133) $45,313
 $(39,664) $1,815,314
Adoption of ASU No. 2016-16 
 
 
 
 
 (22,430) (22,430)
Share issuances 300
 422
 
 (422) 
 
 
Stock-based compensation plans 38
 52
 2,996
 180
 
 
 3,228
Net income 
 
 
 
 
 13,273
 13,273
Other comprehensive income 
 
 
 
 9,597
 
 9,597
March 31, 2018 48,628
 $75,224
 $1,738,044
 $(375) $54,910
 $(48,821) $1,818,982


The table below presents the change in each component of AOCI, net of tax, and the reclassifications out of AOCI into net earningsincome for the ninethree months ended September 30, 2017March 31, 2019 and September 30, 2016March 31, 2018 (in thousands):
  Change in Unrealized Gain (Loss) on Derivatives 
Foreign Currency Translation Adjustments Gain (Loss) (1)
 Total
As of December 31, 2016 $3,619
 $(72,106) $(68,487)
Other comprehensive (loss) income before reclassifications, before tax (10,124) 111,123
 100,999
Tax benefit 2,784
 
 2,784
Other comprehensive (loss) income before reclassifications, net of tax (7,340) 111,123
 103,783
Reclassification of loss from accumulated other comprehensive income, before tax 4,201
 
 4,201
Tax benefit (1,028) 
 (1,028)
Reclassification of loss from accumulated other comprehensive income, after tax 3,173
 
 3,173
Net current-period other comprehensive (loss) income, net of tax (4,167) 111,123
 106,956
As of September 30, 2017 $(548) $39,017
 $38,469
       
As of December 31, 2015 $888
 $(55,116) $(54,228)
Other comprehensive (loss) income before reclassifications, before tax (5,970) 32,598
 26,628
Tax benefit 1,792
 
 1,792
Other comprehensive (loss) income before reclassifications, net of tax (4,178) 32,598
 28,420
Reclassification of loss from accumulated other comprehensive income, before tax 746
 
 746
Tax benefit (279) 
 (279)
Reclassification of loss from accumulated other comprehensive income, after tax 467
 
 467
Net current-period other comprehensive (loss) income, net of tax (3,711) 32,598
 28,887
As of September 30, 2016 $(2,823) $(22,518) $(25,341)
  Change in Unrealized Gain (Loss) on Derivatives 
Foreign Currency Translation Adjustments Gain (Loss) (1)
 Total
As of December 31, 2018 $(944) $(23,532) $(24,476)
Other comprehensive income (loss) before reclassifications, before tax 1,309
 (4,229) (2,920)
Tax expense (314) 
 (314)
Other comprehensive income (loss) before reclassifications, net of tax 995
 (4,229) (3,234)
Reclassification of gain from accumulated other comprehensive income (loss), before tax (1,319) 
 (1,319)
Reclassification of tax expense 316
 
 316
Reclassification of gain from accumulated other comprehensive income (loss), after tax (1,003) 
 (1,003)
Net current-period other comprehensive loss, net of tax (8) (4,229) (4,237)
As of March 31, 2019 $(952) $(27,761) $(28,713)
       
As of December 31, 2017 $(919) $46,232
 $45,313
Other comprehensive income before reclassifications, before tax 214
 10,552
 10,766
Tax benefit (51) 
 (51)
Other comprehensive income before reclassifications, net of tax 163
 10,552
 10,715
Reclassification of gain from accumulated other comprehensive income, before tax (1,471) 
 (1,471)
Reclassification of tax benefit 353
 
 353
Reclassification of gain from accumulated other comprehensive income, after tax (1,118) 
 (1,118)
Net current-period other comprehensive (loss) income, net of tax (955) 10,552
 9,597
As of March 31, 2018 $(1,874) $56,784
 $54,910
(1)Taxes are not provided for foreign currency translation adjustments as translation adjustments are related to earnings that are intended to be reinvested in the countries where earned.
Note 11.13. Stock-Based Incentive Plans
Stock-based incentive plans compensation expense is as follows (in thousands):
 Three Months Ended September 30, Nine Months Ended September 30, Three Months Ended March 31,
 2017 2016 2017 2016 2019 2018
Service-based restricted stock units ("RSUs") $2,970
 $2,156
Service-based stock appreciation rights ("SARs") $2,535
 $1,983
 $6,001
 $6,567
 2,008
 1,348
Service-based restricted stock units ("RSUs") 2,225
 2,517
 6,718
 8,419
Market performance-based restricted stock units 301
 14
 482
 17
 551
 345
Operating performance-based restricted stock units 636
 254
 1,060
 572
 971
 848
Employee stock purchase plan 372
 
Total stock-based compensation expense $5,697
 $4,768
 $14,261
 $15,575
 $6,872
 $4,697
During the ninethree months ended September 30, 2017,March 31, 2019, we executedissued stock-based compensatory award agreementsawards with contract terms agreed upon by us and the respective individuals, as approved by the Compensation Committee of our Board of


Directors. AwardsThe awards with service conditions generally vest ratably over four years, subject to forfeiture unless service conditions are met. Market performance-based awards cliff vest ratably over fourafter three years subject to forfeiture unless certain future pricesthe rank of our shares ontotal shareholder return for the NASDAQ Stock Market exceed certain threshold prices inthree-year period ending December 31, 2021 relative to the first year following the grant date. And finally, operating performance-basedtotal shareholder returns for a peer group of companies. Operating performance-


based awards cliff vest ratably over fourafter three years subject to forfeiture unlessthe achievement of certain thresholds of cumulative adjusted net sales and adjusted net income are metfree cash flow for fiscalthe three year 2017.period ending December 31, 2021. Compensation expense related to award agreements executedawards granted during 20172019 for the three and nine months ended September 30, 2017 were $2.0March 31, 2019 was $0.1 million.
On January 1, 2019, we initiated the LivaNova Global Employee Share Purchase Plan (“ESPP”). Compensation expense related to the ESPP for the three months ended March 31, 2019 was $0.4 million and $3.2 million, respectively..
Stock-based compensation agreements executedissued during the ninethree months ended September 30, 2017,March 31, 2019, representing potential shares and their weighted average grant date fair values by type follows (shares in thousands, fair value in dollars):
 Nine Months Ended September 30, 2017 Three Months Ended March 31, 2019
 Shares Weighted Average Grant Date Fair Value Shares Weighted Average Grant Date Fair Value
Service-based SARs 639
 $17.03
 577
 $31.40
Service-based RSUs 108
 $57.37
 234
 $97.25
Market performance-based RSUs 158
 $25.29
 43
 $101.10
Operating performance-based RSUs 189
 $56.18
 43
 $97.25
Note 12.14. Income Taxes
During the three and nine months ended September 30, 2017, we recorded consolidated income tax expense of $1.9 million and $10.9 million, respectively, with consolidatedOur effective income tax rates of 6.1% and 9.3%, respectively.
rate from continuing operations for the three months ended March 31, 2019 was 30.8% compared with 17.6% for the three months ended March 31, 2018. Our consolidated effective income tax rate fluctuates based on, among other factors, changes in pretax income in countries with varying statutory tax rates, changes in valuation allowances, changes in tax credits and incentives, and changes in unrecognized tax benefits associated with uncertain tax positions.
Compared with the three months ended March 31, 2018, the increase in the effective tax rate for the three and nine months ended September 30, 2017 included the impact of variousMarch 31, 2019 was primarily attributable to a realized benefit from discrete tax items including the release of an uncertain tax position.
We operate in multiple jurisdictions throughout the world, and our tax returns are periodically audited or subjected to review by tax authorities. As a net $4.0result, there is an uncertainty in income taxes recognized in our financial statements. Tax benefits totaling $19.1 million deferred tax benefitand $22.9 million were unrecognized as of March 31, 2019 and December 31, 2018, respectively. It is reasonably possible that, within the next twelve months, due to the releasesettlement of valuation allowances onuncertain tax losses uponpositions with various tax authorities and the completionexpiration of a reorganizationstatutes of our legal entitieslimitations, unrecognized tax benefits could decrease by up to approximately $1.2 million.
We monitor income tax developments in countries where we conduct business. In 2017, the U.S. enacted the “Tax Cuts and a $2.1 million tax benefit fromJobs Act” (the “Tax Act”). To determine the resolutionfull effects of prior period tax matters. Discrete tax items for the nine months ended September 30, 2017 also includedTax Act, we are awaiting the acquisitionfinalization of Caisson and the $38.1 million non-taxable gain recognized to re-measure our existing equity investment in Caisson at fair value on the acquisition date, a $3.9 million deferred tax benefit associated with certain temporary differences arising from the Mergers and the recognition of a $3.0 million deferred tax asset related to a reserve for an uncertain tax position recognized in a prior year, in addition to various other discrete items.
During the three and nine months ended September 30, 2016, we recorded consolidated income tax expense of $9.7 million and $16.9 million, respectively, with consolidated effective income tax rates of 45.7% and 514.5%, respectively. The effective tax rate for the nine months ended September 30, 2016 was impacted by the recording of valuation allowances of $23.9 million related to certain tax jurisdictions, including France and the UK, in which we did not record tax benefits generated by their operating losses,several proposed U.S. Treasury regulations that were issued during 2018, as well as the tax expense generated by profitable operations in higher tax jurisdictions, such asadditional regulations to be proposed and finalized pursuant to the U.S. and Germany, offset byTreasury’s expanded regulatory authority under the Tax Act. It is also possible that technical correction legislation concerning the Tax Act could retroactively affect tax savings from our inter-company financing as part of our 2015 tax restructuring.liabilities for 2018. In addition, state legislative changes addressing conformity to the Tax Act are still pending.


Note 13.15. Net Income (Loss) Per Share
The following table sets forthReconciliation of the computation ofshares used in the basic and diluted net income (loss)earnings per share computations for the three months ended March 31, 2019 and March 31, 2018 are as follows (in thousands, except per share data)thousands):
  Three Months Ended September 30, Nine Months Ended September 30,
  2017 2016 2017 2016
Numerator:        
Net income (loss) $27,830
 $(1,569) $86,599
 $(32,990)
         
Denominator:        
Basic weighted average shares outstanding 48,181
 49,075
 48,130
 49,016
Add effects of share-based compensation instruments (1)
 353
 
 209
 
Diluted weighted average shares outstanding 48,534
 49,075
 48,339
 49,016
Basic income (loss) per share $0.58
 $(0.03) $1.80
 $(0.67)
Diluted income (loss) per share $0.57
 $(0.03) $1.79
 $(0.67)
  Three Months Ended March 31,
  2019 2018
Basic weighted average shares outstanding 48,246
 48,324
Add effects of share-based compensation instruments (1)
 
 863
Diluted weighted average shares outstanding 48,246
 49,187
(1)
Excluded from the computation of diluted earnings per share for the three and nine months ended September 30, 2017March 31, 2019 and March 31, 2018 were1.6 million stock options and SARs outstanding as of September 30, 2017, because to include them would have been anti-dilutive. Excluded from the computation of diluted earnings per share for the three and nine months ended September 30, 2016 were approximately 2.3 million stock options, SARs and restricted share units outstanding as of September 30, 2016,totaling 3.3 million and 0.8 million, because to include them would have been anti-dilutive due tounder the net losses.
treasury stock method.


Note 14.16. Geographic and Segment Information
Segment Information
We identify operating segments based on the way we manage, evaluate and internally report our business activities for purposes of allocating resources and assessing performance. We have threetwo reportable segments: Cardiac Surgery, Neuromodulation,Cardiovascular and Cardiac Rhythm Management.Neuromodulation.
The Cardiac SurgeryCardiovascular segment generates its revenue from the development, production and sale of cardiovascular surgery products. Cardiac Surgerycardiopulmonary products, heart valves and advanced circulatory support. Cardiopulmonary products include oxygenators, heart-lung machines, autotransfusion systems, perfusion tubing systems, cannulae and other related accessories. Heart valves include mechanical heart valves, and tissue heart valves.valves and related repair products. Advanced circulatory support includes temporary life support product kits that can include a combination of pumps, oxygenators, and cannulae.
TheOur Neuromodulation segment generates its revenue from the design, development and marketing of neuromodulation therapy systems for the treatment of drug-resistant epilepsy and treatment resistant depression.Treatment-Resistant Depression (“TRD”). Neuromodulation products include the VNS Therapy System, which consists of an implantable pulse generator, a lead that connects the generator to the vagus nerve, surgical equipment to assist with the implant procedure, equipment to enable the treating physician to set the pulse generator stimulation parametersand other accessories. Our Neuromodulation segment also includes an implantable device for the treatment of obstructive sleep apnea that stimulates multiple tongue muscles via the hypoglossal nerve, which opens the airway while a patient instruction manuals and magnets to suspend or induce stimulation manually.
The Cardiac Rhythm Management segment generates its revenue from the development, manufacturing and marketing of products for the diagnosis, treatment, and management of heart rhythm disorders and heart failure. Cardiac Rhythm Management products include high-voltage defibrillators, cardiac resynchronization therapy devices and low-voltage pacemakers.is sleeping.
“Other” includes Corporatecorporate shared servicesservice expenses for finance, legal, human resources and information technology and Corporatecorporate business development (“and New Ventures”). New Ventures, which includes our recent Caisson acquisition, is focused on new growth platforms and identification of other opportunities for expansion.Ventures.
Net sales of our reportable segments include end-customer revenues from the sale of products they each develop and manufacture or distribute. We define segment income as operating income before merger and integration, restructuring and amortization of intangibles.


NetWe operate under three geographic regions: U.S., Europe, and Rest of world. The table below presents net sales by operating segment and income from operations by segmentgeographic region (in thousands):
  Three Months Ended September 30, Nine Months Ended September 30,
Net Sales: 2017 2016 2017 2016
Cardiac Surgery $159,822
 $148,518
 $457,612
 $453,012
Neuromodulation 91,016
 89,504
 275,190
 260,901
Cardiac Rhythm Management 58,411
 56,768
 182,235
 188,057
Other 415
 478
 1,119
 1,314
  $309,664
 $295,268
 $916,156
 $903,284
  Three Months Ended March 31,
  2019 2018
Cardiopulmonary    
United States $39,123
 $38,445
Europe 35,561
 36,870
Rest of world 46,886
 49,815
  121,570
 125,130
Heart Valves    
United States 4,356
 6,536
Europe 10,513
 12,116
Rest of world 10,804
 12,390
  25,673
 31,042
Advanced Circulatory Support    
United States 8,033
 
Europe 119
 
Rest of world 96
 
  8,248
 
Cardiovascular    
United States 51,512
 44,981
Europe 46,193
 48,986
Rest of world 57,786
 62,205
  155,491
 156,172
Neuromodulation    
United States 76,886
 77,992
Europe 10,659
 10,291
Rest of world 7,104
 5,561
  94,649
 93,844
     
Other 661
 382
Totals    
United States 128,398
 122,973
Europe (1)
 56,852
 59,277
Rest of world 65,551
 68,148
Total (2)
 $250,801
 $250,398
(1)Europe sales include those countries in which we have a direct sales presence, whereas European countries in which we sell through distributors are included in Rest of world.
(2)No single customer represented over 10% of our consolidated net sales. No country’s net sales exceeded 10% of our consolidated sales except for the U.S.

  Three Months Ended September 30, Nine Months Ended September 30,
Income from Operations: 2017 2016 2017 2016
Cardiac Surgery $23,807
 $17,791
 $63,490
 $29,197
Neuromodulation 45,932
 47,049
 139,357
 134,871
Cardiac Rhythm Management 5,427
 (4,598) 13,536
 (14,432)
Other (27,947) (13,525) (79,378) (49,090)
Total Reportable Segments’ Income from Operations 47,219
 46,717
 137,005
 100,546
Merger and integration expenses 2,013
 7,576
 7,743
 20,537
Restructuring expenses 792
 4,381
 12,060
 37,219
Amortization of intangibles 12,350
 11,775
 35,445
 33,959
Income from operations $32,064
 $22,985
 $81,757
 $8,831

The following tables present our assets and capital expenditures bytable below presents a reconciliation of segment income from continuing operations to consolidated income from continuing operations before tax (in thousands):
Assets: September 30, 2017 December 31, 2016
Cardiac Surgery $1,414,260
 $1,277,799
Neuromodulation 564,785
 611,085
Cardiac Rhythm Management 351,390
 341,998
Other 272,695
 111,749
  $2,603,130
 $2,342,631
  Three Months Ended March 31,
Operating Income from Continuing Operations 2019 2018
Cardiovascular $989
 $10,258
Neuromodulation 21,631
 38,734
Other (28,299) (22,820)
Total reportable segment (loss) income from continuing operations (5,679) 26,172
Merger and integration expenses 3,251
 2,960
Restructuring expenses 2,533
 1,881
Amortization of intangibles 9,316
 8,801
Operating (loss) income from continuing operations (20,779) 12,530
Interest income 249
 447
Interest expense (1,662) (2,111)
Gain on acquisition 
 11,484
Foreign exchange and other gains (losses) 729
 (273)
(Loss) income from continuing operations before tax $(21,463) $22,077
Assets by reportable segment are as follows (in thousands):
  Three Months Ended September 30, Nine Months Ended September 30,
Capital expenditures: 2017 2016 2017 2016
Cardiac Surgery $5,541
 $6,465
 $13,292
 $16,774
Neuromodulation 370
 1,781
 2,348
 5,602
Cardiac Rhythm Management 1,537
 1,591
 4,343
 2,786
Other 1,633
 2,435
 4,021
 3,766
  $9,081
 $12,272
 $24,004
 $28,928
Assets March 31, 2019 December 31, 2018
Cardiovascular $1,561,813
 $1,532,825
Neuromodulation 733,307
 731,840
Other 304,424
 285,036
Total assets $2,599,544
 $2,549,701

Capital expenditures by segment are as follows (in thousands):

  Three Months Ended March 31,
Capital expenditures 2019 2018
Cardiovascular $3,551
 $3,131
Neuromodulation 403
 347
Other 929
 1,443
Discontinued operations 
 925
Total $4,883
 $5,846
The changes in the carrying amount of goodwill by reportable segment for the ninethree months ended September 30, 2017March 31, 2019 were as follows (in thousands):
  Neuromodulation Cardiac Surgery Cardiac Rhythm Management Other Total
December 31, 2016 $315,943
 $375,769
 $
 $
 $691,712
Goodwill as a result of acquisitions (1)
 
 
 
 42,418
 42,418
Foreign currency adjustments 
 46,940
 
 
 46,940
September 30, 2017 $315,943
 $422,709
 $
 $42,418
 $781,070
(1)Goodwill recognized as a result of the Caisson acquisition. Refer to “Note 2. Acquisitions.”
Geographic Information
  Neuromodulation Cardiovascular Other Total
December 31, 2018 $398,539
 $515,859
 $42,417
 $956,815
Measurement period adjustments 
 (3,326) 
 (3,326)
Foreign currency adjustments 216
 (1,588) 
 (1,372)
March 31, 2019 $398,755
 $510,945
 $42,417
 $952,117
We operate under three geographic regions: United States, Europe, and Rest of world. Net sales to external customers by geography are determined based on the country the products are shipped to and are as follows (in thousands):

  Three Months Ended September 30, Nine Months Ended September 30,
Net Sales 2017 2016 2017 2016
United States $122,208
 $123,810
 $366,115
 $362,358
Europe (1) (2)
 92,953
 91,245
 294,338
 301,727
Rest of world 94,503
 80,213
 255,703
 239,199
Total (3)
 $309,664
 $295,268
 $916,156
 $903,284
(1)
Net sales to external customers in the UK include $9.6 million and $26.8 millionfor the three and nine months ended September 30, 2017, respectively and $8.8 million and $27.9 million for the three and nine months ended September 30, 2016, respectively.
(2)Includes those countries in Europe where we have a direct sales presence. Countries where sales are made through distributors are included in ‘Rest of world’.
(3)No single customer represented over 10% of our consolidated net sales. Except for the U.S. and France, no country’s net sales exceeded 10% of our consolidated net sales. French sales were $29.6 million and $96.6 million for the three and nine months ended September 30, 2017, respectively, and $28.9 million and $95.9 million for the three and nine months ended September 30, 2016, respectively.
Property, plant and equipment, net by geography are as follows (in thousands):
PP&E September 30, 2017 December 31, 2016 March 31, 2019 December 31, 2018
United States $62,630
 $61,279
 $67,611
 $68,862
Europe 137,682
 130,777
 108,391
 112,376
Rest of world 13,457
 31,786
 9,945
 10,162
Total $213,769
 $223,842
 $185,947
 $191,400
Note 15.17. Supplemental Financial Information
Accounts receivable, net, consisted of the following (in thousands):
  September 30, 2017 December 31, 2016
Trade receivables from third parties $326,498
 $285,336
Allowance for bad debt (12,457) (9,606)
  $314,041
 $275,730


Inventories consisted of the following (in thousands):

 September 30, 2017 December 31, 2016 March 31, 2019 December 31, 2018
Raw materials $51,628
 $47,704
 $41,662
 $40,387
Work-in-process 39,873
 32,316
 21,934
 15,999
Finished goods 123,092
 103,469
 97,671
 97,149
 $214,593
 $183,489
 $161,267
 $153,535
Inventories are reported net of the provision for obsolescence. This provision, which reflects normal obsolescence whichand includes components that are phased out or expired, totaled $13.7$12.5 million and $9.8$11.6 million at September 30, 2017March 31, 2019 and December 31, 2016,2018, respectively.
Prepaid expenses and other current assets consisted of the following (in thousands):
  September 30, 2017 December 31, 2016
Income taxes payable on inter-company transfers of property (1)
 $19,445
 $19,445
Deposits and advances to suppliers 7,298
 5,417
Earthquake grant receivable 4,983
 4,748
Unbilled receivables 4,363
 
Escrow deposit - Caisson 2,000
 
Current loans and notes receivable 1,553
 7,093
Derivative contract assets 
 8,269
Other prepaid expenses 15,534
 11,001
  $55,176
 $55,973
(1)
The income taxes payable on intercompany transfers of property asset is the asset account created to defer the income tax effect of an intercompany intellectual property sale pursuant to ASC 810-10-45-8.
Other assets consisted of the following (in thousands):
  September 30, 2017 December 31, 2016
Income taxes payable on inter-company transfers of property (1)
 $109,971
 $124,551
Investments (2)
 2,316
 2,537
Loans and notes receivable 1,964
 2,029
Escrow deposit - Caisson 1,000
 
Guaranteed deposits 777
 940
Other 1,827
 641
  $117,855
 $130,698
(1)The income taxes payable on intercompany transfers of property asset is the asset account created to defer the income tax effect of an intercompany intellectual property sale pursuant to ASC 810-10-45-8.
(2)Primarily cash surrender value of company owned life insurance policies.


Accrued liabilities and other consisted of the following (in thousands):
  September 30, 2017 December 31, 2016
Product remediation liability (1)
 $20,060
 $23,464
Deferred compensation - Caisson acquisition 14,137
 
Legal and other administrative costs 7,863
 6,184
Provisions for agents, returns and other 8,505
 7,271
Restructuring related liabilities 5,098
 16,859
Product warranty obligations 1,747
 2,736
Royalty costs 2,048
 2,503
Escrow indemnity liability - Caisson 2,000
 
Deferred income 4,752
 
Government grants 1,275
 1,708
Derivative contract liabilities (2)
 3,055
 942
Research and development costs 1,173
 839
Other 20,499
 13,061
  $92,212
 $75,567
  March 31, 2019 December 31, 2018
Contingent consideration (1)
 $42,302
 $18,530
Legal and administrative costs 23,386
 9,189
CRM purchase price adjustment payable to MicroPort Scientific Corporation 14,891
 14,891
Operating lease liabilities (2)
 10,779
 
Product remediation (3)
 11,521
 13,945
Other amounts payable to MicroPort Scientific Corporation 5,105
 9,319
Restructuring related liabilities (4)
 4,396
 9,393
Provisions for agents, returns and other 4,549
 4,934
Derivative contract liabilities (5)
 1,759
 5,063
Other accrued expenses 31,848
 39,021
  $150,536
 $124,285
(1)Refer to “Note 4. Product Remediation Liability.”7. Fair Value Measurements”
(2)
Refer to “Note 8. Derivatives and Risk Management.Note 10. Leases
Other long-term liabilities consisted of the following (in thousands):

 September 30, 2017 December 31, 2016
Contingent consideration (1)
 $34,217
 $3,890
Uncertain tax positions 12,349
 11,108
Product remediation liability (2)
 10,186
 10,023
Government grants 5,889
 3,803
Derivative contract liabilities (3)
 932
 1,392
Escrow indemnity liability - Caisson 1,000
 
Unfavorable operating leases (4)
 256
 1,672
Other 9,575
 7,599
  $74,404
 $39,487
(1)The contingent consideration liability represents contingent payments related to three acquisitions: the first and second acquisitions, in September 2015, were Cellplex PTY Ltd. in Australia and the commercial activities of a local distributor in Colombia. The contingent payments for the first acquisition are based on achievement of sales targets by the acquiree through June 30, 2018 and the contingent payments for the second acquisition are based on sales of cardiopulmonary disposable products and heart lung machines of the acquiree through December 2019. Refer to “Note 6. Fair Value Measurements.” The third acquisition, Caisson, occurred in May 2017. Refer to “Note 2. Acquisitions.”
(2)Refer to “Note 4. Product Remediation Liability.”
(3)Refer to “Note 8. Derivatives and Risk Management.”5. Product Remediation Liability”
(4)Unfavorable operating leases represent the adjustmentRefer to recognize future lease obligations at their estimated fair value in conjunction with the Mergers.“Note 4. Restructuring”
(5)
Refer to “Note 9. Derivatives and Risk Management
As of March 31, 2019 and December 31, 2018, contract liabilities of $5.5 million and $4.8 million, respectively, are included within accrued liabilities and other and other long-term liabilities on the condensed consolidated balance sheets.


Note 16.18. New Accounting Pronouncements
Adoption of New Accounting Pronouncements
In May 2014, the FinancialThe following table provides a description of our adoption of new Accounting Standards BoardUpdates (“FASB”ASUs”) issued ASC Update (“ASU”) No. 2014-09, Revenue from Contracts with Customers. Update No. 2014-09 requires an entity to recognizeby the amountFASB and the impact of revenue to which it expects to be entitled for the transfer of promised goods or services to customers and will replace most existing revenue recognition guidance when it becomes effective. This new standard is effective for annual reporting periods beginning after December 15, 2017, and interim periods within that reporting period. The standard permits the use of either the retrospective or cumulative effect transition method. We will adopt the new standard under the cumulative effect transition method.adoption on our condensed financial statements:
Issue Date & StandardDescriptionDate of AdoptionEffect on Financial Statements or Other Significant Matters
February 2016
ASU No. 2016-02, Leases (Topic 842) and subsequent amendments
The standard requires lessees to recognize most leases on the balance sheet as lease liabilities with corresponding right-of-use (“ROU”) assets and to provide enhanced disclosures. Furthermore, from a lessor perspective, certain of our agreements that allow the customer to use, rather than purchase, our medical devices met the criteria of being a lease in accordance with the new standard.January 1, 2019Adoption of the new standard resulted in the recognition of ROU assets and lease liabilities of approximately $60 million as of January 1, 2019. Refer to “Note 10. Leases.”
June 2018
ASU No. 2018-07, Compensation—Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting
This update simplifies the accounting for non-employee share-based payment transactions.January 1, 2019There was no material impact to our condensed consolidated financial statements as a result of adopting this ASU.


Based on the Company’s evaluation performed to date, we believe the timingFuture Adoption of revenue recognition for products and related revenue streams within our Neuromodulation and Cardiac Rhythm Management segments will not materially change. New Accounting Pronouncements
The Company continues to evaluate the impactfollowing table provides a description of thefuture adoptions of new standard on the timing of when revenue will be recognized for equipment sales and certain services performed within our Cardiac Surgery segment specifically related to heart-lung machines and preventive maintenance contracts on cardiopulmonary equipment.
Upon adoption of the new standard, we expect to implement new internal controls related to our accounting policies and procedures, including review controls to ensure contractual terms and conditionsstandards that may require consideration under the standard are properly identified and analyzed. During the fourth quarter of 2017, we expect to finalize ourhave an impact assessment and redesign impacted processes, policies and controls.
In January 2016, the FASB issued ASU No. 2016-01, Financial Instruments-Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities. Update 2016-01 requires equity investments that do not result in consolidation and are not accounted for under the equity method to be measured at fair value with changes recognized in net income. However, an entity may elect to measure equity investments that do not have readily determinable fair values at cost minus impairment, if any, plus or minus changes resulting from observable price changes in orderly transactions for the identical or a similar investment of the same issuer. The amendments, in addition, reduce complexity of the impairment assessment of equity investments without readily determinable fair values with regard to the other-than-temporary impairment guidance. The amendments also require separate presentation of financial assets and financial liabilities by measurement category and form of financial asset and liability. This guidance is effective for fiscal years beginning after December 15, 2017, including interim periods within those fiscal years. Early application of certain provisions is permitted. We are currently evaluating the effect this standard will have on our consolidated financial statements and related disclosures.when adopted:
In February 2016, the FASB issued ASU No. 2016-02, Leases. This guidance requires lessees to recognize most leases on their balance sheets as lease liabilities with corresponding right-of-use assets. While many aspects of lessor accounting remain the same, the new standard makes some changes, such as eliminating the current real estate-specific guidance. The new standard requires lessees and lessors to classify most leases using a principle generally consistent with that of “IAS 17 - Leases,” which is similar to U.S. GAAP but without the use of bright lines. The standard also changes what is considered initial direct costs. Entities are required to use a modified retrospective approach for leases that exist or are entered into after the beginning of the earliest comparative period in the financial statements. The standard is effective for annual periods beginning after December 15, 2018 and interim periods within that year. Early adoption is permitted. We are currently evaluating the effect this standard will have on our consolidated financial statements and related disclosures.
In March 2016, the FASB issued ASU No. 2016-09, Compensation—Stock Compensation: Improvements to Employee Share-Based Payment Accounting. This simplified the accounting for certain aspects of share-based payment transactions including the income tax consequences, classification of awards as either equity or liabilities and classification on the statement of cash flows. We adopted the amendments of ASU 2016-09 (each “an Amendment”) effective January 1, 2017, using the following methods:
We adopted the Amendment that requires all of the tax effects related to the settlement of share based compensation awards to be recorded through the income statement on a prospective basis. The adoption of this Amendment did not have a material effect on income tax expense for the nine months ended September 30, 2017.
We adopted the Amendment related to cash flow presentation of tax-related cash flows resulting from share based payments on a prospective basis. The Amendment stipulates that all tax-related cash flows resulting from share based payments are to be reported as operating activities in the statement of cash flows, rather than, under past requirements, to present gross windfall tax benefits as an inflow from financing activities and an outflow from operating activities.
Under the Amendment related to forfeitures, entities are permitted to make a company-wide accounting policy election to either estimate forfeitures each period, as required prior to this Amendment’s effective date, or to account for forfeitures as they occur. We elected to continue to account for forfeitures using the estimation method.
We adopted the Amendment related to the timing of when excess tax benefits are recognized, which requires that all windfalls and shortfalls be recognized when they arise. There were no unrecognized excess tax benefits prior to the adoption of the Amendment.
In August 2016, the FASB issued ASU No. 2016-15, Classification of Certain Cash Receipts and Cash Payments(Topic 230 -Statement of Cash Flows). Update 2016-15 provides guidance on the presentation and classification of certain cash receipts and cash payments in the statement of cash flows including debt prepayment or debt extinguishment costs, settlement of zero-coupon debt instruments, contingent consideration payments made after a business combination,
Issue Date & StandardDescriptionProjected Date of AdoptionEffect on Financial Statements or Other Significant Matters
June 2016
ASU No. 2016-13, Financial Instruments—Credit Losses (Topic 326)
The amendments in this update require a financial asset (or a group of financial assets) measured at amortized cost basis to be presented at the net amount expected to be collected. The modified-retrospective approach is generally applicable through a cumulative-effect adjustment to retained earnings as of the beginning of the first reporting period in which the guidance is effective. Early adoption is permitted.January 1, 2020We are currently evaluating the effect this standard will have on our condensed consolidated financial statements and related disclosures.
January 2017
ASU No. 2017-04, 
Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment
This update removes step 2 of the goodwill impairment test that compares the implied fair value of goodwill with its carrying amount. Instead, an impairment test is performed by comparing the fair value of a reporting unit with its carrying amount. An impairment charge will be recorded by the amount a reporting unit’s carrying amount exceeds its fair value. Early adoption is permitted.January 1, 2020We are currently evaluating the effect this standard will have on our condensed consolidated financial statements and related disclosures.
August 2018
ASU No. 2018-13, Fair Value Measurement (Topic 820): Changes to the Disclosure Requirements for Fair Value Measurement
This update removes, modifies and adds certain disclosure requirements related to fair value measurements. Early adoption is permitted.January 1, 2020We do not expect the adoption of this update to have a material effect on our condensed consolidated financial statement disclosures.
August 2018
ASU No. 2018-14, Compensation—Retirement Benefits—Defined Benefit Plans—General(Subtopic 715-20): Changes to the Disclosure Requirements for Defined Benefit Plans
This update adds and removes certain disclosure requirements related to defined benefit plans. This ASU is to be implemented on a retrospective basis for all periods presented with early adoption permitted.January 1, 2021We do not expect the adoption of this update to have a material effect on our condensed consolidated financial statement disclosures.
August 2018
ASU No. 2018-15, Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract
This update clarifies and aligns the accounting for implementation costs for hosting arrangements with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. This ASU is to be applied either retrospectively or prospectively with early adoption permitted.January 1, 2020We do not expect the adoption of this update to have a material effect on our condensed consolidated financial statements.


proceeds from the settlement of insurance claims, proceeds from the settlement of corporate-owned life insurance policies, and distributions received from equity method investees. The amendments are effective for fiscal years beginning after December 15, 2017, and interim periods within those fiscal years. The amendments should be applied using a retrospective transition method to each period presented. We are currently evaluating the effect this standard will have on our consolidated financial statements and related disclosures.
In October 2016, the FASB issued ASU No. 2016-16, Income Taxes - Intra-Entity Transfers of Assets Other Than Inventory (Topic 740). This update simplifies the accounting for the income tax consequences of transfers of assets from one unit of a corporation to another unit or subsidiary by eliminating an accounting exception that prevents the recognition of current and deferred income tax consequences for such “intra-entity transfers” until the assets have been sold to an outside party. The amendment should be applied using a modified retrospective transition method by means of a cumulative-effect adjustment directly to retained earnings as of the beginning of the period in which the guidance is adopted. The rule is effective for annual periods after December 15, 2017, including interim periods within those annual reporting periods. We currently estimate the cumulative-effect reduction to retained earnings to be approximately $65.2 million upon adoption at January 1, 2018.
In January 2017, the FASB issued ASU No. 2017-04, Intangibles-Goodwill and Other - Simplifying the Test for Goodwill Impairment (Topic 350). This update removes step 2 of the goodwill impairment test that compares the implied fair value of goodwill with its carrying amount. Instead, an impairment test is performed by comparing the fair value of a reporting unit with its carrying amount. An impairment charge will be recorded by the amount a reporting unit’s carrying amount exceeds its fair value. The rule is effective for annual periods after December 15, 2019, including interim periods within those annual reporting periods. We are currently evaluating the impact of adopting this update on our consolidated financial statements.
In March 2017, the FASB issued ASU No. 2017-01, Business Combinations (Topic 805)—Clarifying the Definition of a Business. This update clarifies when a set of assets and activities is a business. The amendments provide a screen to determine when a set is not a business. The screen requires that when substantially all of the fair value of the gross assets acquired is concentrated in a single identifiable asset or a group of similar identifiable assets, the set is not a business. If the screen is not met, the amendments in this Update (1) require that to be considered a business, a set must include, at a minimum, an input and a substantive process that together significantly contribute to the ability to create output and (2) remove the evaluation of whether a market participant could replace missing elements. This update is effective for annual periods after December 15, 2017, including interim periods within those annual reporting periods. We are currently evaluating the impact of adopting this update on our consolidated financial statements.
In March 2017, the FASB issued ASU No. 2017-07, Compensation—Retirement Benefits (Topic 715): Improving the Presentation of Net Periodic Pension Cost and Net Periodic Post Retirement Benefit Cost. This update requires that an employer report the service cost component in the same line item or items as other compensation costs arising from services rendered by the pertinent employees during the period. The other components of net benefit cost are required to be presented in the income statement separately from the service cost component and outside a subtotal of income from operations, if one is presented. If a separate line item or items are used to present the other components of net benefit cost, that line item or items must be appropriately described. If a separate line item or items are not used, the line item or items used in the income statement to present the other components of net benefit cost must be disclosed. The amendments in this Update also allow only the service cost component to be eligible for capitalization when applicable. This Update is effective for annual periods after December 15, 2017, including interim periods within those annual reporting periods. We are currently evaluating the impact of adopting this update on our consolidated financial statements.
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
The following discussion and analysis should be read in conjunction with our condensed consolidated financial statements and related notes which appear elsewhere in this document and with our Annual Report on2018 Form 10-K for the year ended December 31, 2016 (“2016 Form 10-K”).10-K. Our discussion and analysis may contain forward-looking statements that involve risks and uncertainties. Our actual results may differ materially from those anticipated in these forward-looking statements as a result of certain factors, including those set forth under “Risk Factors” in Item 1A of our 20162018 Form 10-K and elsewhere in this quarterly report.
The capitalized terms used below have been defined in the notes to our condensed consolidated financial statements. In the following text, the terms “LivaNova,” “the Company,” “we,” “us” and “our” refer to LivaNova PLC and its consolidated subsidiaries.


Business Overview
We are a public limited company organized under the laws of England and Wales, headquartered in London, United Kingdom.England. We are a global medical device company focused on the development and delivery of important therapeutic solutions for the benefit of patients, healthcare professionals and healthcare systems throughout the world. Working closely with medical professionals in the fields of Cardiac Surgery,Cardiovascular and Neuromodulation, and Cardiac Rhythm Management, we design, develop, manufacture and sell innovative therapeutic solutions that are consistent with our mission to improve our patients’ quality of life, increase the skills and capabilities of healthcare professionals and minimize healthcare costs.
Sale of the CRM Business Franchise
We completed the CRM Sale on April 30, 2018 for total cash proceeds of $195.9 million, less cash transferred of $9.2 million, subject to a closing working capital adjustment. The results of operations of CRM are reflected as discontinued operations for all periods presented in this Quarterly Report on Form 10-Q. Refer to “Note 3. Discontinued Operations” to the condensed consolidated financial statements in this Quarterly Report on Form 10-Q.
Business Franchises
We operateLivaNova is comprised of two principal business franchises, which are also our business through threereportable segments: Cardiac Surgery,Cardiovascular and Neuromodulation, and Cardiac Rhythm Management. Our three reportable segments correspondcorresponding to our Business Franchises and each Business Franchise corresponds to one of our three mainprimary therapeutic areas aligned to best serve our customers. Corporateareas. Other corporate activities include corporate business development (“shared service expenses for finance, legal, human resources, information technology and New Ventures”). New Ventures is focused on new growth platforms and identification of other opportunities for expansion and investment.Ventures.
For further information regarding our business segments, historical financial information and our methodology for the presentation of financial results, please refer to the condensed consolidated financial statements and accompanying notes of this Quarterly Report on Form 10-Q.
Cardiac SurgeryCardiovascular Update
On October 5, 2015, we announced the initiation of PERSIST-AVR, the first international, prospective post-market randomized multi-center clinical study evaluating the Perceval sutureless aortic valve compared to standard sutured bioprostheses in patients with aortic valve disease. The Perceval valve, the only sutureless biological aortic valve replacement (“AVR”) on the market today, employs a unique self-anchoring frame that enables the surgeon to replace the diseased valve without suturing it into place. The studyOur Cardiovascular business franchise is expected to enroll 1,234 patients within a two-year enrollment period and patients will be followed until five years post procedure. In January 2017, the independent study, “Aortic Valve Replacement With Sutureless Perceval Bioprosthesis: Single-Center Experience With 617 Implants,” was presented to The Society of Thoracic Surgeons. The study found AVR procedures conducted with the Perceval sutureless valve resulted in low mortality and excellent hemodynamic performance for patients.
In January 2016, we announced FDA approval of the Perceval sutureless valve. While we have been selling Perceval in other parts of the world for several years, we began commercial distribution of the deviceengaged in the United States last year, with the first implant announced on March 8, 2016. The Perceval valve has been implanted in more than 25,000 patients in more than 310 hospitals in 34 countries across the world.development, production and sale of cardiopulmonary products, heart valves and advanced circulatory support products. Cardiopulmonary products include oxygenators, heart-lung machines, autotransfusion systems, perfusion tubing systems, cannulae and other related accessories. Heart valves include mechanical heart valves, tissue heart valves and related repair products. Advanced circulatory support includes temporary life support product kits that can include a combination of pumps, oxygenators, and cannulae.
In early February 2016, we announced that we received FDA approval of our CROWN PRTvalve for the treatment of aortic valve disease. TheCROWN PRTvalve uses a stented aortic bioprosthesis technology and features a surgeon-friendly design, with optimized hemodynamics and a patented phospholipid reduction treatment (“PRT”), designed to enhance valve durability. We anticipate launching the CROWN PRT valve in the U.S. later this year.Product Remediation Plan
In March 2017, we committed to a plan to sell our Suzhou Industrial Park facility in Shanghai, China, an emerging market greenfield project for the local manufacture of Cardiopulmonary disposable products in Suzhou Industrial Park in China. As a result of this exit plan, we recorded an impairment of the building and equipment of $4.6 million and accrued $0.5 million of additional costs, primarily related to employee severance, during the nine months ended September 30, 2017, included in ‘Restructuring expenses’ in the condensed consolidated statement of income (loss). In addition, the land, building and equipment were recorded as ‘Assets held for sale’ on the condensed consolidated balance sheet, with a carrying value of $14.1 million as of September 30, 2017.
In September 2017, we received FDA 510(k) clearance for the U.S. market launch of our Optiflow Arterial Cannulae Family. Optiflow aortic arch cannulae provide improved hydrodynamics with a novel dispersive tip design that improves blood flow characteristics resulting in reduced wall shear stress (“WSS”) profiles. Optiflow Arterial cannulae feature a unique basket tip with large openings that allow a more physiologically compatible dispersive design. This design has been shown to significantly reduce WSS and turbulence, thereby improving hydrodynamics and potentially reducing ischemic complications from extracorporeal circulation during cardiac surgery.
3T Heater-Cooler Devices
FDA Warning Letter.
On December 29, 2015, the FDA issued LivaNova a Warning Letter (the “Warning Letter”) alleging certain violations of FDA regulations applicable to medical device manufacturers at our Munich, Germany and Arvada, Colorado facilities.


The FDA inspected the Munich facility from August 24, 2015 to August 27, 2015facilities and the Arvada facility from August 24, 2015 to September 1, 2015. On August 27, 2015, the FDA issued a Form 483 identifying two observed non-conformities with certain regulatory requirements at the Munich facility. We did not receive a Form 483 in connection with theinspectional observations on FDA’s inspection of the Arvada facility. Following the receipt of the Form 483, we provided written responses to the FDA describing corrective and preventive actions that were underway or to be taken to address the FDA’s observations at the Munich facility. The Warning Letter responded in partForm-483 applicable to our responses and identified other alleged violations not previously included in the Form 483.Munich, Germany facility.
The Warning Letter further stated that our 3T devices and other devices we manufactured at our Munich facility are subject to refusal of admission into the U.S. until resolution of the issues set forth by the FDA in the Warning Letter. The FDA has informed us that the import alert is limited to the 3T devices, but that the agency reserves the right to expand the scope of the import alert if future circumstances warrant such action. The Warning Letter did not request that existing users cease using the 3T device, and manufacturing and shipment of all of our products other than the 3T device remain unaffected by the import limitation. To help clarify these issues for current customers, we issued an informational Customer Letter in January 2016 and that same month agreed with the FDA on a process for shipping 3T devices to existing U.S. users pursuant to a certificate of medical necessity program.
Finally, the Warning Letter stated that premarket approval applications for Class III devices to which certain Quality System regulation deviations identified in the Warning Letter are reasonably related will not be approved until the violations have been corrected. However,


corrected; however, this restriction applies only to the Munich and Arvada facilities, which do not manufacture or design devices subject to Class III premarket approval.
We continue to work diligently to remediate the FDA’s inspectional observations for the Munich facility, as well as the additional issues identified in the Warning Letter. We take these matters seriously and intend to respond timely and fully to the FDA’s requests. For further information, please refer to “Note 5. Product Remediation Liability” in our condensed consolidated financial statements included in this Quarterly Report on Form 10-Q.
CDCProduct Liability
The Company is currently involved in litigation involving our 3T device. As of April 30, 2019, we are aware of approximately 210 filed and FDA Safety Communicationsunfiled claims worldwide, with the majority of the claims in various federal or state courts throughout the United States. On March 29, 2019, we announced a settlement framework that provides for a comprehensive resolution of the personal injury cases pending in the multi-district litigation in U.S. federal court, the related class action pending in federal court, as well as certain cases in state courts across the United States. The agreement, which makes no admission of liability, is subject to certain conditions, including acceptance of the settlement by individual claimants and Company Field Safety Notice Update
On October 13, 2016provides for a total payment of up to $225 million to resolve the Centers for Disease Control and Prevention (“CDC”) and FDA separately released safety notifications regardingclaims covered by the 3T devices. The CDC’s Morbidity and Mortality Weekly Report (“MMWR”) and Health Advisory Notice (“HAN”) reported that tests conducted by CDC and its affiliates indicate that there appearssettlement, with up to $135 million to be genetic similarity between both patientpaid no earlier than July 2019 and 3T device strains of the non-tuberculous mycobacterium (“NTM”) bacteria M. chimaera isolatedremainder in hospitalsJanuary 2020. However, cases in Iowa and Pennsylvania. Citing the geographic separation between the two hospitals referencedstate courts in the investigation,U.S. and in jurisdictions outside the report asserts that 3T devices manufactured priorU.S. continue to August 18, 2014 could have been contaminated during the manufacturing process. The CDC’s HAN and FDA’s Safety Communication, issued contemporaneously with the MMWR report, each assess certain risks associated with 3T devices and provide guidance for providers and patients. The CDC notification states that the decision to use the 3T device during a surgical operation is to be taken by the surgeon based on a risk approach and on patient need. Both the CDC’s and FDA’s communications confirm that 3T devices are critical medical devices and enable doctors to perform life-saving cardiac surgery procedures.
Also on October 13, 2016, we issued a Field Safety Notice Update for U.S. users of 3T devices to proactively and voluntarily contact facilities to aid in implementation of the CDC and FDA recommendations.progress. In the fourth quarter of 2016, we initiated a program to provide existing 3T device users with a new loaner 3T device at no charge pending regulatory approval and implementation of additional risk mitigation strategies worldwide. This loaner program began in the U.S. and is being made available progressively on a global basis, prioritizing and allocating devices to 3T device users based on pre-established criteria. We anticipate that this program will continue until we are able to address customer needs through a broader solution that includes implementation of one or more of the risk mitigation strategies currently under review with regulatory agencies.
On December 31, 2016,2018, we recognized a $294.1 million provision, which represents our best estimate of the Company’s liability for our product remediation plan related to our 3T device. We concluded that it was probable that a liability had been incurred upon management’s approval ofthese matters. At March 31, 2019, the plan and the commitments made by management to various regulatory authorities globally in November and December 2016, and furthermore, the cost associated with the plan was reasonably estimable. At September 30, 2017, the product remediation liability was $30.2 million. Referprovision estimate remains unchanged. For further information refer to “Note 4. Product Remediation Liability” for additional information.11. Commitments and Contingencies.”

Heart Valves

Litigation
OnIn February 12, 2016, LivaNova was alerted2019, we announced that a class action complaint had been filed in the U.S. District CourtJapan’s Ministry of Health, Labour and Welfare granted national reimbursement for the Middle District of Pennsylvania with respectPerceval sutureless aortic heart valve to our 3T devices. The plaintiffs named in the complaint underwent open heart surgeries at WellSpan York Hospital and Penn State Milton S. Hershey Medical Center in 2015, and the complaint alleges that: (i) patients were exposed to a harmful form of bacteria, known as nontuberculous mycobacterium (“NTM”), from our 3T devices; and (ii) we knew or should have known that design or manufacturing defects in 3T devices can lead to NTM bacterial colonization, regardless of the cleaning and disinfection procedures used (and recommended by us). The class of plaintiffs in the complaint consists of all Pennsylvania residents who underwent open heart surgery at WellSpan York Hospital and Penn State Milton S. Hershey Medical Center between 2011 and 2015 and who currently are asymptomatic for NTM infection.
On October 23, 2017, the U.S. District Court for the Middle District of Pennsylvania issued an order certifying a class with respect to the named plaintiffs. The class action, which is currently against Sorin Group Deutschland GmbH and Sorin Group USA, Inc. seeks: (i) declaratory relief finding the 3T devices are defective and unsafe for intended uses; (ii) medical monitoring; (iii) general damages; and (iv) attorneys’ fees. Other lawsuits related to surgeries in which a 3T device allegedly was used have been filed elsewhere in the U.S., as well as in Canada, and Europe, against various LivaNova entities.
We are defending each of these claims vigorously. Given the relatively early stage of these matters, we cannot give any assurances that additional legal proceedings making the same or similar allegations will not be filed against us or one of our subsidiaries, nor that the resolution of these complaints or other related litigation will not have a material adverse effect on our business, results of operations, financial condition or liquidity. We have not recognized an expense related to damages in connection with these matters because any potential loss is not currently probable or reasonably estimable. In addition we cannot reasonably estimate a range of potential loss, if any, that may result from these matters.treat aortic valve disease.
Neuromodulation Update
Epilepsy
Our product development efforts are directed toward improvingNeuromodulation business franchise designs, develops and markets neuromodulation therapy for the VNS Therapy Systemtreatment of drug-resistant epilepsy, TRD and developing new products that provide additional features and functionality.obstructive sleep apnea. We are conducting ongoing product development activities to enhance the VNS Therapy System pulse generator, lead and programming software. We will be required to obtain appropriate U.S. and international regulatory approvals, and clinical studies may be a prerequisite to regulatory approvals for some products.
In June 2017, the FDA approved our VNS Therapy device for use in patients who are at least four years of age and have partial onset seizures that are refractory to antiepileptic medications. VNS Therapy is the first and only FDA-approved device for drug-resistant epilepsy in this pediatric population. Previously, VNS Therapy was approved by the FDA for patients 12 years or older.
In addition, in June 2017, we received FDA approval, and in August CE Mark approval, for our VNS Therapy device for expanded magnetic resonance imaging (“MRI”) labeling affirming VNS Therapy as the only epilepsy device approved by the FDA for MRI scans. Currently, SenTiva, AspireHC and AspireSR models of VNS Therapy technology provide for this expanded MRI access.
In October 2017, we obtained FDA approval to market our SenTiva VNS Therapy System, which consists of the SenTiva implantable generator and the next-generation VNS Therapy Programming System. SenTiva is the smallest and lightest responsive therapy for epilepsy. The new VNS Therapy Programming System features a wireless wand and new user interface on a small tablet. Together, the components offer patients with drug-resistant epilepsy a physician-directed customizable therapy with smart technology and proven results that reduce the number of seizures, lessen the duration of seizures and enable a faster recovery.
Depression
In March 2017, the American Journal of Psychiatry published the results of the longest and largest naturalistic study on effective treatments for patients experiencing chronic and severe depression. The findings showed that the addition of VNS Therapy to traditional treatment methods is effective in reducing symptoms in patients with treatment-resistant depression.
Cardiac Rhythm Management (“CRM”) Update
In September 2017, we announced that we had commenced a process to explore strategic options to realize the full value of our CRM Business Franchise. While our Board of Directors has approved examining strategic options, amongst which is the possibility of divestiture, no commitment to a plan of sale has been made. Accordingly, the CRM business franchise was not reported as an asset held for sale as of September 30, 2017.


Also in September 2017, we announced that the Company’s Shanghai-based joint venture MicroPort Sorin Cardiac Rhythm Management Co. Ltd. obtained approval for its family of Rega™ pacemakers from the China Food and Drug Administration.
New Ventures Update
Heart failure
With respect to heart failure, New Ventures isalso focused on the development and clinical testing of the VITARIA®VITARIA System for treating heart failure through vagus nerve stimulation.
We received CE Mark approvalDepression
In February 2019, we announced that the U.S. Centers for Medicare & Medicaid Services (“CMS”) finalized its National Coverage Determination (“NCD”) for the LivaNova Vagus Nerve Stimulation Therapy (“VNS Therapy”) System for TRD. This final decision initiates coverage for Medicare beneficiaries through Coverage with Evidence Development (“CED”) when offered in a CMS-approved, double-blind, randomized, placebo-controlled trial with a follow-up duration of at least one year, as well as the VITARIA System in February 2015 for patients who have moderate to severe heart failure (New York Heart Association Class II/III) with left ventricular dysfunction (ejection fraction < 40%) and who remain symptomatic despite stable, optimal heart failure drug therapy. The VITARIA System provides a specific methodcoverage of VNS called autonomic regulation therapy (“ART”), and itTherapy device replacement. The CED also includes the same elements aspossibility to extend the VNS Therapy System - pulse generator, lead, programming wand and software, programming computer, tunneling tool and accessory pack - without the patient kit with magnets. We conductedstudy to a pilot study, ANTHEM-HF, outside the United States, which concluded in 2014. The study results support the safety and efficacy of ART delivered by the VITARIA System. We submitted the results to our European Notified Body, DEKRA, and on February 20, 2015, we received CE Mark approval. The VITARIA System is not approved in the U.S. During 2014, we also initiated a second pilot study, ANTHEM-HFpEF, to study ART in patients experiencing symptomatic heart failure with preserved ejection fraction. This pilot study is currently underway outside the United States.
Obstructive sleep apnea
ImThera Medical, Inc. (“ImThera”) is a privately held, emerging-growth company developing an implantable neurostimulation device system for the treatment of obstructive sleep apnea. We have an investment of $12.0 million in ImThera, and a $1.0 million note receivable due from ImThera for a loan made during the nine months ended September 30, 2017 to fund operating expenses.
Mitral valve regurgitation
Mitral regurgitation (“MR”) occurs when the heart’s mitral valve does not close tightly, which allows blood to flow backwards in the heart. This reduces the amount of blood that flows to the rest of the body, making the patient feel tired or out of breath. Treatment depends on the nature and the severity of MR. In certain cases, heart surgery may be needed to repair or replace the valve. Left untreated, severe mitral valve regurgitation can cause heart failure or heart rhythm problems (arrhythmias).
On May 2, 2017, we agreed to pay up to $72.0 million to acquire the remaining 51% equity interests in Caisson in support of our strategic growth initiatives. Caisson is developing a device for treating mitral regurgitation through replacement of the native mitral valve using a fully transvenous delivery system. As a result of our acquisition of Caisson, we began consolidating the results of Caisson as of May 2, 2017. In April 2016, we obtained FDA approval of an Investigational Device Exemption study using Caisson technology for treating mitral regurgitation heart failure with transcatheter mitral valve replacement and we are currently executing against a defined clinical data development plan designed to enable commercialization of the Caisson technology.
We are also invested in two mitral valve startups. Cardiosolutions Inc. and Highlife. Cardiosolutions, a startup headquartered in the U.S. in which we have held an interest since 2012, is developing an innovative spacer technology for treating mitral regurgitation. Highlife, headquartered in France, is focused on developing devices for treating mitral regurgitation through percutaneous replacement of the native mitral valve. We recognized an impairment of our equity method investment in, and notes receivable from, Highlife during the nine months ended September 30, 2017. The estimated fair value of our investment and notes receivable were below our carrying value by $13.0 million.prospective longitudinal study.
Significant Accounting Policies and Critical Accounting Estimates 
There have been no material changesIn addition to our critical accounting policies from the information provided in “Part II, Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations” included in our 20162018 Form 10-K. 10-K, refer to “Significant Accounting Policies” within “Note 1. Unaudited Condensed Consolidated Financial Statements” included in this Quarterly Report on Form 10-Q.
The accompanying unaudited condensed consolidated financial statements of LivaNova and its consolidated subsidiaries have been prepared in accordance with U.S. GAAP on an interim basis.
New accounting pronouncements are disclosed in “Note 16.18. New Accounting Pronouncements” contained in the condensed consolidated financial statements in this Quarterly Report on Form 10-Q.


Other
Brexit
On June 23, 2016, the UK held a referendum in which voters approved an exit from the EU, commonly referred to as “Brexit.” On March 29, 2017, the UK government gave formal notice of its intention to leave the EU formally commencingand began the negotiations regarding the termsprocess of withdrawal between the UK and the EU. The withdrawal must occur within two years, unless the deadline is extended. The negotiation process will determinenegotiating the future terms of the UK’s relationship with the EU. Brexit could adversely affect UK, regional (including European) and worldwide economic and market conditions and could contribute to instability in global financial and foreign exchange markets, including volatility in the value of the British Pound and Euro. We have foreign exchange exposure management programs designed to help minimize the impact from foreign currency exchange rate movements. For the three


months ended March 31, 2019 and 2018, net sales generated from our European operations constituted approximately 22.7% and 23.7%, respectively, of total net sales.
Negotiations between the UK and the EU continue about provisions of the withdrawal agreement. Unless the deadline is further extended, the UK will leave the EU on October 31, 2019. Although the long-term effects of Brexit will depend on any agreements the UK makes to retain access to the EU markets, Brexit has created additional uncertainties that may ultimately result in new regulatory costs and challenges for medical device companies and increased restrictions on imports and exports throughout Europe. This could adversely affect our ability to conduct and expand our operations in Europe and may have an adverse effect on our overall business, financial condition and results of operations. For additional information on how Brexit could affect our business, see Part I, Item 1A Risk Factors-“The UK’s vote in favor of withdrawing from the EU could lead to increased market volatility and make it more difficult for us to do business in Europe or have other adverse effects on our business” of our 2018 Form 10-K.
The notification does not change the application of existing tax laws and does not establish a clear framework for what the ultimate outcome of the negotiations and legislative process will be.
Various tax reliefs and exemptions that apply to transactions between EU Member States under existing tax laws may cease to apply to transactions between the UK and EU Member States when the UK ultimately withdraws from the EU. It is unclear at this stage if or when any new tax treaties between the UK and the EU or individual EU Member States will replace those reliefs and exemptions. It is also unclear at this stage what financial, trade and legal implications will ensue from Brexit and how Brexit may ultimately affect us, our customers, suppliers, vendors, or our industry.
SeveralWe and several of our wholly owned subsidiaries that are domiciled either in the UK, various EU Member States, or in the United Sates, and our parent company, LivaNova PLC,U.S., are party to intercompany transactions and agreements under which we receive various tax reliefs and exemptions in accordance with applicable international tax laws, treaties and regulations. If certain treaties applicable to our transactions and agreements are not renegotiated or replaced with new treaties containing terms, conditions and attributes similar to those of the existing treaties,change materially, Brexit may have a material adverse impact on our future financial results and results of operations. During the two-year negotiation period, we willWe continue to monitor and assess the potential impact of this event and explore possible tax-planning strategies that may mitigate or eliminate any such potential adverse impact. event.
We will not account for the impact of Brexit in our income tax provisions until changes in tax laws or treaties between the UK and the EU or individual EU Member States with the UK and/or the U.S. are enacted, or the withdrawal becomes effective.
The Trump Administration has included as part of its agenda a potential reform of U.S. tax laws.  European Union State Aid Challenge
On September 27,October 26, 2017, the White House released its “Unified Framework for Fixing Our Broken Tax Code” (the “Framework”European Commission (“EC”), which was developed announced that an investigation will be opened with respect to the UK’s controlled foreign company (“CFC”) rules. The CFC rules under investigation provide group finance exemptions ("GFE") to entities controlled by UK parent companies that are subject to lower tax rates if the activities being undertaken by the Trump Administration,CFC relate to financing. On April 2, 2019, the House CommitteeEC concluded that “when financing income from a foreign group company, channeled through an offshore subsidiary, is financed with UK connected capital and there are no UK activities involved in generating the finance profits, the group finance exemption is justified and does not constitute State aid under EU rules.” However, in relation to Significant People Functions, “when financing income from a foreign group company, channeled through an offshore subsidiary, derives from UK activities, the group finance exemption is not justified and constitutes State aid under EU rules.” HMRC has stated that they do not consider the timing and form of the UK’s exit from the EU will have a practical impact on Ways and Means,the requirement to recover the alleged aid. Within the coming weeks, HMRC will provide details as to how it will be recovering the amounts required by the decision. Based upon our assessment of the issue and the Senate Committee on Finance and which includes specific goals for lower businesslimited level of UK activities involved in our financing, no uncertain tax rates. The Framework calls for a 20% corporate tax rate and international reforms that include a territorial tax system and a one-time mandatory repatriation tax. The Framework proposes 100% expensing of new investments in depreciable assets for five years, effective after September 27, 2017, while partially limiting the tax deduction for net business interest expense. Additionally, the Framework would repeal the section 199 domestic manufacturing deduction and “numerous other special exclusions and deductions” but would retain the research tax credit. The content of any final legislation, the timing for enactment, and the reporting periods that would be impacted cannot be determined atposition reserve has been recognized related to this time.

matter.


Results of Operations
We are reporting, in this Quarterly Report on Form 10-Q, the results for LivaNova and its consolidated subsidiaries for the three and nine months ended September 30, 2017,March 31, 2019, as compared to the three and nine months ended September 30, 2016.March 31, 2018.
The following table summarizes our condensed consolidated results of operations (in thousands):
 Three Months Ended September 30, Nine Months Ended September 30, Three Months Ended March 31,
 2017 2016 2017 2016 2019 2018
Net sales $309,664
 $295,268
 $916,156
 $903,284
 $250,801
 $250,398
Cost of sales 108,233
 106,454
 318,584
 360,675
Costs and expenses:    
Cost of sales - exclusive of amortization 84,254
 84,598
Product remediation 1,642
 689
 2,573
 2,243
 2,947
 3,715
Gross profit 199,789
 188,125
 594,999
 540,366
Operating expenses:        
Selling, general and administrative 121,177
 109,233
 353,943
 345,744
 125,704
 104,161
Research and development 31,393
 32,175
 104,051
 94,076
 43,575
 31,752
Merger and integration expenses 2,013
 7,576
 7,743
 20,537
 3,251
 2,960
Restructuring expenses 792
 4,381
 12,060
 37,219
 2,533
 1,881
Amortization of intangibles 12,350
 11,775
 35,445
 33,959
 9,316
 8,801
Total operating expenses 167,725
 165,140
 513,242
 531,535
Income from operations 32,064
 22,985
 81,757
 8,831
Operating (loss) income from continuing operations (20,779) 12,530
Interest income 199
 585
 724
 1,119
 249
 447
Interest expense (1,421) (3,495) (5,314) (6,665) (1,662) (2,111)
Gain on acquisition of Caisson Interventional, LLC 
 
 39,428
 
Gain on acquisition 
 11,484
Foreign exchange and other gains (losses) 491
 1,216
 957
 (2) 729
 (273)
Income before income taxes 31,333
 21,291
 117,552
 3,283
Income tax expense 1,913
 9,731
 10,881
 16,891
(Loss) income from continuing operations before tax (21,463) 22,077
Income tax (benefit) expense (6,614) 3,893
Losses from equity method investments (1,590) (13,129) (20,072) (19,382) 
 (362)
Net income (loss) $27,830
 $(1,569) $86,599
 $(32,990)
Net (loss) income from continuing operations (14,849) 17,822
Net loss from discontinued operations, net of tax 
 (4,549)
Net (loss) income $(14,849) $13,273


Net Sales
The tabletables below illustratespresent net sales by operating segment and market geographygeographic region (in thousands, except for percentages):
  Three Months Ended September 30,  
  2017 2016 % Change
Cardiac Surgery      
United States $44,991
 $46,768
 (3.8)%
Europe (1)
 40,429
 38,009
 6.4%
Rest of world 74,402
 63,741
 16.7%
  159,822
 148,518
 7.6%
Neuromodulation      
United States 76,286
 74,864
 1.9%
Europe (1)
 8,057
 8,489
 (5.1)%
Rest of world 6,673
 6,151
 8.5%
  91,016
 89,504
 1.7%
Cardiac Rhythm Management      
United States 931
 2,178
 (57.3)%
Europe (1)
 44,468
 44,747
 (0.6)%
Rest of world 13,012
 9,843
 32.2%
  58,411
 56,768
 2.9%
Other 415
 478
 (13.2)%
  $309,664
 $295,268
 4.9%
 Nine Months Ended September 30,  Three Months Ended March 31,
 2017 2016 % Change 2019 2018 % Increase (Decrease)
Cardiac Surgery     
Cardiopulmonary      
United States $39,123
 $38,445
 1.8 %
Europe 35,561
 36,870
 (3.6)%
Rest of world 46,886
 49,815
 (5.9)%
 121,570
 125,130
 (2.8)%
Heart Valves      
United States $129,160
 $133,995
 (3.6)% 4,356
 6,536
 (33.4)%
Europe (1)
 126,028
 128,229
 (1.7)% 10,513
 12,116
 (13.2)%
Rest of world 202,424
 190,788
 6.1% 10,804
 12,390
 (12.8)%
 457,612
 453,012
 1.0% 25,673
 31,042
 (17.3)%
Advanced Circulatory Support      
United States 8,033
 
 
Europe 119
 
 
Rest of world 96
 
 
 8,248
 
 
Cardiovascular      
United States 51,512
 44,981
 14.5 %
Europe 46,193
 48,986
 (5.7)%
Rest of world 57,786
 62,205
 (7.1)%
 155,491
 156,172
 (0.4)%
Neuromodulation           
United States 76,886
 77,992
 (1.4)%
Europe 10,659
 10,291
 3.6 %
Rest of world 7,104
 5,561
 27.7 %
 94,649
 93,844
 0.9 %
      
Other 661
 382
 73.0 %
Totals      
United States 231,350
 220,892
 4.7% 128,398
 122,973
 4.4 %
Europe (1)
 25,500
 24,208
 5.3% 56,852
 59,277
 (4.1)%
Rest of world 18,340
 15,801
 16.1% 65,551
 68,148
 (3.8)%
 275,190
 260,901
 5.5%
Cardiac Rhythm Management     
United States 5,605
 7,471
 (25.0)%
Europe (1)
 142,811
 149,141
 (4.2)%
Rest of world 33,819
 31,445
 7.5%
 182,235
 188,057
 (3.1)%
Other 1,119
 1,314
 (14.8)%
 $916,156
 $903,284
 1.4%
Total $250,801
 $250,398
 0.2 %
(1)IncludesEurope sales include those countries in Europe where LivaNova haswhich we have a direct sales presence. Countries where sales are madepresence, whereas European countries in which we sell through distributors are included in ‘Rest“Rest of world’.world.”


The tabletables below illustratespresent segment income (loss) from operations (in thousands):
  Three Months Ended September 30,  
  2017 2016 % Change
Cardiac Surgery $23,807
 $17,791
 33.8 %
Neuromodulation 45,932
 47,049
 (2.4)%
Cardiac Rhythm Management 5,427
 (4,598) 218.0 %
Other (27,947) (13,525) (106.6)%
Total Reportable Segment's Income from Operations (1)
 $47,219
 $46,717
 1.1 %
  Nine Months Ended September 30,  
  2017 2016 % Change
Cardiac Surgery $63,490
 $29,197
 117.5 %
Neuromodulation 139,357
 134,871
 3.3 %
Cardiac Rhythm Management 13,536
 (14,432) 193.8 %
Other (79,378) (49,090) (61.7)%
Total Reportable Segment's Income from Operations (1)
 $137,005
 $100,546
 36.3 %
  Three Months Ended March 31,
  2019 2018 % Change
Cardiovascular $989
 $10,258
 (90.4)%
Neuromodulation 21,631
 38,734
 (44.2)%
Other (28,299) (22,820) 24.0 %
Total reportable segment income from continuing operations (1)
 $(5,679) $26,172
 (121.7)%
(1)
For a reconciliation of segment operating income to consolidated operating income refer to “Note 14.16. Geographic and Segment Information” inin the condensed consolidated financial statements in this Quarterly Report on Form 10-Q.
Cardiac SurgeryCardiovascular
Cardiovascular net sales increased by 7.6% and 1.0% for the three and nine months ended September 30, 2017, as compared to the three and nine months ended September 30, 2016, respectively. Net sales increased $11.3decreased $0.7 million or 0.4% for the three months ended September 30, 2017, asMarch 31, 2019 compared to the prior-year periodthree months ended March 31, 2018. This decrease was primarily due to growth in bothdecreased cardiopulmonary product revenue and heart valve revenuesales of $3.6 million and favorable$5.4 million, respectively, offset by an increase in advanced circulatory support sales of $8.2 million due to the inclusion of the operating results of TandemLife starting from the acquisition date in April 2018. Cardiopulmonary sales of $121.6 million were positively impacted by double-digit growth in heart-lung machines, as customers continue to upgrade from our legacy S3 device to our current S5 device, and strong growth in oxygenators, but were more than offset by the impact of exiting of a distribution agreement on January 1, 2019 that accounted for $7.8 million in sales during the three months ended March 31, 2018 and unfavorable foreign currency exchange rate fluctuations. Cardiopulmonaryfluctuations during the three months ended March 31, 2019. Heart valve sales increased 7.6%,of $25.7 million were negatively impacted by declines in sales of mechanical and tissue heart valves and unfavorable foreign currency exchange rate fluctuations during the three months ended March 31, 2019.
Cardiovascular operating income decreased $9.3 million or $8.7 million,90.4% or for the three months ended September 30, 2017,March 31, 2019 compared to the three months ended March 31, 2018 primarily due to strength in heart-lung machines as a result of geographic sales expansionincreased R&D investments and continued progress towards upgrading customers from older machines toincreased legal costs associated with our current S53T device. Heart valve
Neuromodulation
Neuromodulation net sales increased by 7.7%,$0.8 million or $2.6 million,0.9% for the three months ended September 30, 2017, asMarch 31, 2019 compared to the prior-year period due primarily to increased demand forthree months ended March 31, 2018 as strong growth in the Perceval sutureless tissue valveEurope and Rest of world regions was mostly offset by unexpected weakness in the U.S. and quarter over quarter improvement in Europe, which more than offset declines in mechanical heart valve sales globally. Cardiac Surgery net sales increased $4.6 million for the nine months ended September 30, 2017, as compared to the nine months ended September 30, 2016, due primarily to growth of $5.3 million in cardiopulmonary product revenue, partially offset by a decline in heart value revenues. Year-to-date cardiopulmonary product sales increased over the prior-year periodmarket principally due to heart-lung machinecompetitive dynamics and sales expansion outside of the U.S. and Europe. Cardiac Surgeryforce turnover.
Neuromodulation operating income decreased $17.1 million or 44.2% for the three months ended September 30, 2017 increased 33.8% overMarch 31, 2019 compared to the prior-year periodthree months ended March 31, 2018 primarily due to increased operating leverage from the $11.3 million increase in sales. The 117.5% increase in operating income for the nine months ended September 30, 2017 over the prior-year period was primarily driven by inventory fair value step-up amortization of $25.2 million that was recognized during the nine months ended September 30, 2016. The inventory fair value step-up was fully amortized by September 30, 2016.
Neuromodulation net salesmarketing expenses and increased by 1.7% and 5.5% for the three and nine months ended September 30, 2017, as compared to the three and nine months ended September 30, 2016, respectively. The increase in net sales of $1.5 million for the three months ended September 30, 2017, over the prior-year period was primarily due to increased average selling prices driven by continued AspireSR penetration of the U.S. market, partially offset by a decline in unit sales due to hurricane-related impacts in the U.S. and customer anticipation of the SenTiva system,R&D expenses associated with our new generationSentiva VNS Therapy System, which launched in October 2017. The increase in net sales of $14.3 million for the nine months ended September 30, 2017 over the prior-year period was primarily due to strong new patient salesTRD and price premiums partially offset by hurricane-related impacts in the U.S. and customer anticipation of the SenTiva system. The decrease in Neuromodulation operating income for the three months ended September 30, 2017 as compared to the prior-year period was primarily due to increased selling, general and administrative costs driven by sales force expansion and marketing efforts in the U.S. The increase in Neuromodulation operating income for the nine months ended September 30, 2017 as compared to the prior-year period was primarily driven by increased operating leverage as a result of higher net sales, partially offset by the increased costs associated with sales force expansion and marketing efforts in the U.S.
Cardiac Rhythm Management net sales increased by 2.9% for the three months ended September 30, 2017, as compared to the prior-year period primarily due to favorable foreign currency exchange rate fluctuations. Additionally, growth of the


PLATINIUM Cardiac Resynchronization Therapy devices (CRT-Ds) in Europe and continued demand for KORA 250 pacemakers in Japan were mostly offset by a decrease in Implantable Cardiac Defibrillator (ICD) sales. Cardiac Rhythm Management net sales decreased by 3.1% for the nine months ended September 30, 2017, as compared to the prior-year period. This decline was primarily due to a decrease in ICD sales and reduced sales in the U.S. and Europe, both of which reflect a change in customer preferences. Cardiac Rhythm Management operating income increased $10.0 million and $28.0 million for the three and nine months ended September 30, 2017, respectively, as compared to the prior-year periods. The increase for the three months ended September 30, 2017 over the prior-year period was due to cost reductions resulting from prior restructuring actions, improvements in selling, general and administrative costs driven by reductions in the overall sales force and increased net sales. The increase for the nine months ended September 30, 2017 as compared to the prior-year period was driven by inventory fair value step-up amortization of $10.0 million that was recognized during the nine months ended September 30, 2016, cost reductions resulting from prior restructuring actions and cost reductions associated with a reduction in the overall sales force partially offset by decreased sales during the nine months ended September 30, 2017.
‘Other’ comprises the results from our corporate and new ventures activity. Operating loss from Other increased $14.4 million for the three months ended September 30, 2017, as compared to the prior-year period, primarily due to $3.9 million of Caisson related expenses and $12.9 million in increased Corporate costs. Operating loss from Other increased $30.3 million for the nine months ended September 30, 2017, as compared to the prior-year period, primarily due to $17.9 million of increased Caisson-related expenses and increased Corporate costs of $20.3 million. Increased Corporate costs during the three and nine months ended September 30, 2017 includes $2.8 million and $8.3 million in legal costs, respectively, primarily associated with litigation related to our 3T devices and investments in building out global capabilities including international expansion, and project-related expenses.heart failure.
Cost of Sales and Expenses
The table below illustratespresents our comparative cost of sales and majorsignificant expenses as a percentage of sales:
  Three Months Ended September 30,  
  2017 2016 Change
Cost of sales 35.0% 36.1% (1.1)%
Product remediation 0.5% 0.2% 0.3 %
Gross profit 64.5% 63.7% 0.8 %
Operating expenses:      
Selling, general and administrative 39.1% 37.0% 2.1 %
Research and development 10.1% 10.9% (0.8)%
Merger and integration expenses 0.7% 2.6% (1.9)%
Restructuring expenses 0.3% 1.5% (1.2)%
Amortization of intangibles 4.0% 4.0%  %
  Nine Months Ended September 30,  
  2017 2016 Change
Cost of sales 34.8% 39.9% (5.1)%
Product remediation 0.3% 0.2% 0.1 %
Gross profit 64.9% 59.8% 5.1 %
Operating expenses:      
Selling, general and administrative 38.6% 38.3% 0.3 %
Research and development 11.4% 10.4% 1.0 %
Merger and integration expenses 0.8% 2.3% (1.5)%
Restructuring expenses 1.3% 4.1% (2.8)%
Amortization of intangibles 3.9% 3.8% 0.1 %


Cost of Sales
Cost of sales consisted primarily of direct labor, allocated manufacturing overhead, the acquisition cost of raw materials and components. Cost of sales as a percentage of net sales decreased by 1.1% to 35.0% and by 5.1% to 34.8% for the three and nine months ended September 30, 2017, respectively, as compared to the prior-year periods. The cost improvement for the three months ended September 30, 2017 reflects management’s focus on cost efficiencies to improve gross margin. The cost improvement for the nine months ended September 30, 2017 was primarily due to inventory fair value step-up amortization in the prior year, which accounted for 3.9% of the decrease in our cost of sales as a percentage of net sales, as well as the previously mentioned cost efficiencies. The total amount recognized for amortization of the fair value step-up in inventory for the nine months ended September 30, 2016 was $35.2 million. The fair value step-up in inventory basis was fully amortized by September 30, 2016.
  Three Months Ended March 31,
  2019 2018 Change
Cost of sales - exclusive of amortization 33.6% 33.8% (0.2)%
Product remediation 1.2% 1.5% (0.3)%
Selling, general and administrative 50.1% 41.6% 8.5 %
Research and development 17.4% 12.7% 4.7 %
Merger and integration expenses 1.3% 1.2% 0.1 %
Restructuring expenses 1.0% 0.8% 0.2 %
Amortization of intangibles 3.7% 3.5% 0.2 %
Sales, General and Administrative (“SG&A”) Expenses
SG&A expenses consisted of sales, marketing, general and administrative activities. SG&A expenses for the three months ended September 30, 2017 increased as a percentage of net sales by 2.1% to 39.1%, asincreased for the three months ended March 31, 2019 compared to the prior-year period, and was consistent at 38.6% for the ninethree months ended September 30, 2017, as comparedMarch 31, 2018 primarily due to the prior-year period. The 2.1% increase was largely attributable toadditional litigation expenses primarily related to our 3T devices, U.S. investments in a direct to consumer campaign for epilepsy, the impact of including and other legal matters.expanding Advanced Circulatory Support commercial capabilities, strengthening our


commercial organization in international markets, expenses associated with the expiration of a contract with one our distributors, and lower than expected overall net sales.
Research and Development (“R&D”) Expenses
R&D expenses consistedconsist of product design and development efforts, clinical trialstudy programs and regulatory activities.activities, which are essential to our strategic portfolio initiatives, including TMVR, TRD, Obstructive Sleep Apnea and Heart Failure. R&D expenses as a percentage of net sales was consistentincreased for the three months ended September 30, 2017, asMarch 31, 2019 compared to the prior-year period, and increased by 1.0% to 11.4% for the nine months ended September 30, 2017, as compared to the prior-year period. The increase is due to the acquisition of Caisson, inclusive of $5.8 million in post-combination compensation expense recognized concurrent with the acquisition of Caisson, and $6.4 million in compensation expense associated with the retention of the employees of Caisson.
Merger and Integration Expenses
Merger and integration expenses consisted primarily of consulting costs associated with computer systems integration efforts, organization structure integration, synergy and tax planning, as well as the integration of internal controls for the two legacy organizations. In addition, integration expenses include retention bonuses, branding and renaming efforts and lease cancellation penalties in Milan and Brussels.
Merger and integration expenses as a percentage of net sales decreased by 1.9% to 0.7% for the three months ended September 30, 2017 as compared to the prior-year period, and decreased by 1.5% to 0.8% for the nine months ended September 30, 2017 as compared to the prior-year period. These decreases were due to a continued decline in integration activities.
Restructuring Expenses
Restructuring expenses wereMarch 31, 2018 primarily due to additional R&D expenses for our efforts under our 2015development of next generation products, including heart-lung machines, the SenTiva VNS Therapy System and 2016 Reorganization PlansTandemLife and the Suzhou, China exit plan, to leverage economies of scale, eliminate duplicate corporate expensesclinical trials and streamline distributions, logisticsstrategic investments in TRD, TMVR, obstructive sleep apnea and office functions in order to reduce overall costs. Restructuring expenses as a percentage of net sales decreased by 1.2% to 0.3% and 2.8% to 1.3% for the three and nine months ended September 30, 2017, respectively, as compared to the prior-year periods due to a continued decline in restructuring activities.heart failure.
Gain on Caisson Acquisition
On May 2, 2017,January 16, 2018, we acquired the remaining 51% equity interests in Caisson which we previously accountedoutstanding interest of ImThera for under the equity method.cash consideration of up to $225 million. On the acquisition date, we remeasured our notes receivable due from Caisson and our existing investment in CaissonImThera at fair value and recognized a pre-tax non-cash gain of $1.3 million and $38.1 million, respectively.
Foreign Exchange and Other Gains (Losses)
Foreign exchange and other gains were $0.5 million and $1.2 million for the three months ended September 30, 2017 and September 30, 2016, respectively. The gains were primarily due to net foreign currency gains associated with foreign currency commercial transactions, freestanding foreign currency forward contracts, intercompany debt, and third-party financial assets and liabilities. The gains of $1.0 million for the nine months ended September 30, 2017 included a $3.2 million gain on a sale of the cost-method investment, Istituto Europeo di Oncologia S.R.L, partially offset by net foreign currency exchange losses of $2.2$11.5 million.


Income Taxes
LivaNova PLC is domiciled and resident in the UK. Our subsidiaries conduct operations and earn income in numerous countries and are subject to the laws of taxing jurisdictions within those countries, and the income tax rates imposed in the tax jurisdictions in which our subsidiaries conduct operations vary. As a result of the changes in the overall level of our income, the deployment ofearnings mix in various tax strategiesjurisdictions and the changes in tax laws, our consolidated effective income tax rate may vary substantially from one reporting period to another.
During the three and nine months ended September 30, 2017, we recorded consolidated income tax expense of $1.9 million and $10.9 million, respectively, with consolidatedOur effective income tax rates of 6.1% and 9.3%, respectively.
rate from continuing operations for the three months ended March 31, 2019 was 30.8% compared with 17.6% for the three months ended March 31, 2018. Our consolidated effective income tax rate fluctuates based on, among other factors, changes in pretax income in countries with varying statutory tax rates, changes in valuation allowances, changes in tax credits and incentives, and changes in unrecognized tax benefits associated with uncertain tax positions.
Compared with the three months ended March 31, 2018, the increase in the effective tax rate for the three and nine months ended September 30, 2017 included the impact of variousMarch 31, 2019 was primarily attributable to a realized benefit from discrete tax items including a net $4.0 million deferred tax benefit due to the release of valuation allowances on tax losses upon the completion of a reorganization of our legal entities in the U.S. and a $2.1 million tax benefit from the resolution of prior period tax matters. Discrete tax items for the nine months ended September 30, 2017 also included the acquisition of Caisson and the $38.1 million non-taxable gain recognized to re-measure our existing equity investment in Caisson at fair value on the acquisition date, a $3.9 million deferred tax benefit associated with certain temporary differences arising from the Mergers and the recognition of a $3.0 million deferred tax asset related to a reserve for an uncertain tax position recognized in a prior year, in addition to various other discrete items.
During the three and nine months ended September 30, 2016, we recorded consolidated income tax expense of $9.7 million and $16.9 million, respectively, with consolidated effective income tax rates of 45.7% and 514.5%, respectively. The effective tax rate for the nine months ended September 30, 2016 was impacted by the recording of valuation allowances of $23.9 million related to certain tax jurisdictions, including France and the UK, in which we did not record tax benefits generated by their operating losses, as well as the tax expense generated by profitable operations in higher tax jurisdictions, such as the U.S. and Germany, offset by tax savings from our inter-company financing as part of our 2015 tax restructuring.
Losses from Equity Method Investments
Losses from equity method investments were $1.6 million and $20.1 million during the three and nine months ended September 30, 2017, respectively. Losses for the three months ended September 30, 2017 were due to our equity method investee losses, primarily from Highlife and MicroPort. Losses for the nine months ended September 30, 2017 included the impairment of our investment in, and notes receivable from, Highlife of $13.0 million, which consisted of the investment impairment of $4.7 million and the notes receivable impairment of $8.3 million. We recognized losses of $13.1 million and $19.4 million during the three and nine months ended September 30, 2016, respectively, primarily due to a $9.2 million impairment of our investment in Respicardia and losses from our equity method investees.position.
Liquidity and Capital Resources
The accompanying condensed consolidated financial statements have been prepared on the basis that LivaNova will continue as a going concern. As further discussed in “Note 11. Commitments and Contingencies,” the Company recorded a $294.1 million litigation provision liability as of December 31, 2018 based on managements’ best estimate, of which $161.9 million is anticipated to be paid during 2019 and the majority of the remainder is expected to be paid in the first half of 2020. In connection with our assessment of going concern considerations as of the issuance date of our 2018 Form 10-K in accordance with ASU 2014-15, “Disclosures of Uncertainties about an Entity’s Ability to Continue as a Going Concern,” the Company determined that collectively the payments of the $294.1 million liability and the $23.3 million of current debt obligations represented a condition that raised substantial doubt about our ability to continue as a going concern. However, on February 25, 2019, the Company received $350 million in aggregate financing commitments pursuant to a Commitment Letter from Bank of America Merrill Lynch International DAC, Barclays Bank PLC, BNP Paribas and Intesa Sanpaolo S.P.A for a debt facility. We concluded that the anticipated execution of the debt facility agreement based on the Commitment Letter, when combined with current and anticipated future operating cash flows, alleviated the substantial doubt about the Company’s ability to continue as a going concern over the 12-month period beginning from the issuance date of our 2018 Form 10-K. On March 26, 2019, we entered into a Facility Agreement that provides a multicurrency term loan facility in an aggregate principal amount of $350 million and terminates on March 26, 2022.
Based on our current business plan, we believe that our existing cash and cash equivalents, future cash generated from operations and available borrowing capacity under our credit facilitiesborrowings will be sufficient to fund our expected operating needs, working capital requirements, R&D opportunities, capital expenditures, obligations anticipated for the litigation involving our 3T device and debt service requirements over the next 12 months. We regularly review12-month period beginning from the issuance date of these financial statements. Accordingly, there are no conditions present as of the issuance date of these financial statements that raise substantial doubt about our capital needs and consider various investing and financing alternativesability to support our requirements.continue as a going concern. Our liquidity could be adversely affected by a material deterioration of future operating results. Refer to “Note 7.8. Financing Arrangements” in the condensed consolidated financial statements in this Quarterly Report on Form 10-Q for additional information regarding our debt. Our liquidity could be adversely affected by the factors affecting future operating results, including those referred to in “Part II - Item 1A. Risk Factors” in 2016 Form 10-K.
On June 29, 2017, we entered into a new Finance Contract with the EIB to support financing of certain of our R&D projects. The Finance Contract has a borrowing base of €100 million (or approximately $118 million) and can be drawn in up to two tranches, each in a minimum amount of €50 million (or approximately $59 million). Drawdowns must occur by December 30, 2018 and the last repayment date of any tranche will be no earlier than four years and no later than eight years after the disbursement of the relevant tranche. Loans under the Finance Contract are subject to certain covenants and other terms and conditions.

No provision has been made for income taxes on unremitted earnings of our foreign controlled subsidiaries (non-UK subsidiaries) as of September 30, 2017.March 31, 2019. In the event of the distribution of those earnings in the form of dividends, a sale of the subsidiaries or certain other transactions, we may be liable for income taxes. However, the tax liability on future distributions should not be significant as most jurisdictions with unremitted earnings have various participation exemptions or no withholding tax.


Cash Flows
Net cash and cash equivalents provided by (used in) operating, investing and financing activities and the net increase (decrease) in the balance of cash and cash equivalents were as follows (in thousands):
 Nine Months Ended September 30, Three Months Ended March 31,
 2017 2016 2019 2018
Operating activities $73,665
 $49,348
 $1,974
 $20,393
Investing activities (41,797) (36,363) (5,641) (83,352)
Financing activities (10,000) (62,996) 7,589
 32,047
Effect of exchange rate changes on cash and cash equivalents 3,501
 1,030
 (350) 2,261
Net increase (decrease) $25,369
 $(48,981) $3,572
 $(28,651)
Operating Activities
Cash provided by operating activities during the ninethree months ended September 30, 2017 increased $24.3March 31, 2019 decreased by $18.4 million as compared to the same prior-year period. The increase wasdecrease is primarily the result of an increasedue to increases in working capital along with a decrease in net income of $119.6 million, offset by a $43.2 million change in operating assets and liabilities, a $39.4 million gain recognized in conjunction with the acquisition of Caisson and a $17.0 million increase in deferred income tax benefit.adjusted for non-cash items.
Investing Activities
Cash used in investing activities during the ninethree months ended September 30, 2017 increased $5.4 million as compared to the same prior-year period. The increase was primarily the result of net cash paid for the acquisition of Caisson of $14.2 million as well as $14.1 million received from maturities of short-term investments in the prior-year period, offset by $7.1 million in purchases of short-term investments in the prior-year period.
Financing Activities
Cash used in financing activities during the nine months ended September 30, 2017March 31, 2019 decreased $53.0$77.7 million as compared to the same prior-year period. The decrease wasis primarily due to the result2018 acquisition of ImThera, net of cash acquired, of $77.6 million.
Financing Activities
Cash provided by financing activities during the three months ended March 31, 2019 decreased $24.5 million as compared to the same prior-year period. The decrease is primarily due to a decrease in net debt repaymentsshort-term borrowing proceeds of $27.5 million, a decrease$20.0 million.
Off-Balance Sheet Arrangements
As of March 31, 2019, we did not have any off-balance sheet arrangements.
Contractual Obligations
We had no material changes in share repurchasesour contractual commitments and obligations from amounts listed under “Part II, Item 7. Management’s Discussion and Analysis of $11.1 millionFinancial Condition and Results of Operations - Liquidity and Capital Resources” in our Annual Report on Form 10-K for the repayment of trade receivable advances of $23.8 million in the prior-year period, offset by a reduction in proceeds from stock option exercises of $4.7 million.year ended December 31, 2018.
Item 3. Quantitative and Qualitative Disclosures About Market Risk
We are exposed to certain market risks as part of our ongoing business operations, including risks from foreign currency exchange rates, interest rate risks and concentration of procurement suppliers that could adversely affect our consolidated financial position, results of operations or cash flows. We manage these risks through regular operating and financing activities and, at certain times, derivative financial instruments. Quantitative and qualitative disclosures about these risks are included in this Form 10-Q in “Part I, Note 8”,9. Derivatives and Risk Management,” “Part I, Item 2. Management’s Discussion and Analysis of Financial Conditions and Results of Operations” and “Part II, Item 1A. Risk Factors”,Factors,” and in our 20162018 Form 10-K in “Part II, Item 7A7. Management’s Discussion and Analysis of Financial Condition and Results of Operations.”Operations” and “Part I, Item 1A. Risk Factors”.Factors.” There have been no material changes from the information provided therein.


Item 4. Controls and Procedures
Disclosure Controls and Procedures
(a) Evaluation of Disclosure Controls and Procedures
We maintain a system of disclosure controls and procedures, as defined in Rules 13a-15(e) and 15d-15(e) of the Exchange Act, that are designed to ensure that information required to be disclosed in our reports filed under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms. This information is also accumulated and communicated to management, including our Chief Executive Officer (“CEO”) and Chief Financial Officer (“CFO”), as appropriate, to allow timely decisions regarding required disclosure. Our management,Management, under the supervision and with the participation of our CEOChief Executive Officer and CFO, evaluatedChief Financial Officer, conducted an evaluation of the effectiveness of the design and operationeffectiveness of our disclosure controls and procedures as of the end of the most recent fiscal quarter reported herein.March 31, 2019. Based on that evaluation, our CEOthe Chief Executive Officer (CEO) and CFOthe Chief Financial Officer (CFO) have concluded that ourthe disclosure controls and procedures were not effective as of September 30, 2017.


that date due to the material weaknesses in internal control over financial reporting that were disclosed in our Annual Report on Form 10-K for the fiscal year ended December 31, 2018.
(b) Changes in Internal Control Over Financial Reporting
We deployedOn January 1, 2019, we implemented a new enterprise resource planning (ERP) software system, SAP, to our U.S. locations during the quarter ended September 30, 2017. In conjunction with the implementation of SAP, we reorganized certain U.S. legal entities were to align with our strategic and operational focus. Ouras well as new internal controls, have been updated to reflectsupport adoption of the new Lease Accounting standard, ASC 842. The operating effectiveness of these changes. There have been nocontrols will be evaluated as part of our annual assessment of the effectiveness of internal controls over financial reporting for the fiscal year ended December 31, 2019. No other changes in ourover internal controlcontrols over financial reporting (as defined in Rules 13a-15(f) and 15d - 5(f) under the Exchange Act) occurred during the quarter ended March 31, 2019.
Remediation
Efforts have been ongoing throughout the quarter to remediate the material weaknesses reported in our 2018 10-K filing. We have begun implementing a new tool, SAP GRC module, that will help us better manage IT and business user access in our ERP system. In addition, we are implementing new controls and formalizing existing controls around price and quantity in our Revenue process. The weaknesses will not be considered remediated, until the applicable controls operate for a sufficient period covered by this Quarterly Report on Form 10-Qof time and management has concluded, through testing, that have materially affected, orthese controls are reasonably likelyoperating effectively. We expect that the remediation of the material weaknesses will be completed prior to materially affect, our internal control over financial reporting.the end of fiscal year 2019.


PART II. OTHER INFORMATION
Item 1. Legal Proceedings
For a description of our material pending legal and regulatory proceedings and settlements, refer to “Note 9.11. Commitments and Contingencies” in our condensed consolidated financial statements included in this Report on Form 10-Q. 
Item 1A. RISKRisk FACTORSFactors
Our business faces many risks. AnyThere were no material changes to the description of the risks referenced below or elsewhere in this Report on Form 10-Q, other Reports on Form 10-Qs or our other SEC filings could have a material impact onrisk factors associated with our business and consolidated financial position or results of operations. Additional risks and uncertainties not presently known to us or that we currently believe to be immaterial may also impair our business operations.
For additional detailed discussion of risk factors that should be understood by any investor contemplating investmentas previously disclosed in our stock, please refer to “Part I.Part I, Item 1A. Risk1A “Risk Factors” in our 2016 Form 10-K and elsewhere as described in this Report on Form 10-Q.
The results of the UK’s referendum on withdrawal from the EU may have a negative effect on global economic conditions, financial markets and our business, which could reduce the price of our ordinary shares.
On June 23, 2016, the UK held a referendum in which voters approved an exit from the EU, commonly referred to as “Brexit.” On March 29, 2017, the UK Government gave formal notice of its intention to leave the EU, formally commencing the negotiations regarding the terms of withdrawal between the UK and the EU. The withdrawal must occur within two years, unless the deadline is extended or a withdrawal agreement is negotiated sooner. The negotiation process will determine the future terms of the UK’s relationship with the EU. The notification does not change the application of existing tax laws, and does not establish a clear framework for what the ultimate outcome of the negotiations and legislative process will be.
Various tax reliefs and exemptions that apply to transactions between EU Member States under existing tax laws may cease to apply to transactions between the UK and EU Member States when the UK ultimately withdraws from the EU. It is unclear at this stage if or when any new tax treaties between the UK and the EU or individual EU Member States will replace those reliefs and exemptions. It is also unclear at this stage what financial, trade and legal implications the withdrawal of the UK from the EU will have and how Brexit may affect us, our customers, suppliers, vendors, or our industry.
Several of our wholly-owned subsidiaries that are domiciled either in the UK, various EU Member States, or in the United States, and our parent company, LivaNova PLC, are party to intercompany transactions and agreements under which we receive various tax reliefs and exemptions. If certain treaties applicable to our transactions and agreements are not renegotiated or replaced with new treaties containing terms, conditions and attributes similar to those of the existing treaties, the departure of the UK from the EU may have a material adverse impact on our future financial results and results of operations. During the two-year negotiation period, We will monitor and assess the potential impact of this event and explore possible tax-planning strategies that may mitigate or eliminate any such potential adverse impact. We will not account for the impact of Brexit in our income tax provisions until changes in tax laws or treaties between the UK and the EU or individual EU Member States are enacted or the withdrawal becomes effective.
Our acquisition of Caisson may fail to further our strategic objectives or strengthen our existing businesses.
Acquisitions of medical technology companies are inherently risky, and we cannot guarantee that such acquisitions will be successful or will not materially adversely affect our consolidated earnings, financial condition, and/or cash flows. Caisson is in the early stages of clinical development, and therefore, there are risks inherent in the outcome of the clinical studies or regulatory approvals that may impact Caisson’s success. Further, our integration of Caisson’s operations requires significant efforts, including the coordination of information technologies, research and development, operations and finance. These efforts result in additional expenses and significant supervision by management. Our failure to manage and coordinate the growth of Caisson successfully could have an adverse impact on our business. In addition, we cannot be certain that the acquisition will become profitable or remain so. These effects, individually or in the aggregate, could cause a deterioration of our credit rating and result in increased borrowing costs and interest expense.2018 Form 10-K.



Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
None
Item 3. Defaults Upon Senior Securities
None.
Item 4. Mine Safety Disclosures
Not applicable.
Item 5. Other Information
None.


Item 6. Exhibits
The exhibits marked with the asterisk symbol (*) are filed or furnished (in the case of Exhibit 32.1) with this Quarterly Report on Form 10-Q. The exhibits marked with the cross symbol (†) are management contracts or compensatory plans or arrangements filed pursuant to Item 601(b)(10)(iii) of Regulation S-K. 
Exhibit
Number
 
Document Description
 
 Report or Registration Statement
SEC File or
Registration
Number
Exhibit
Reference
3.2 LivaNova Plc Current Report on Form 8-K, filed on June 15, 2017001-375993.1
31.1*    
31.2*    
32.1*    
101*Interactive Data Files Pursuant to Rule 405 of Regulation S-T: (i) the Condensed Consolidated Statement of Income (Loss) for the three and nine months ended September 30, 2017 and September 30, 2016, (ii) the Condensed Consolidated Statement of Comprehensive Income for the three and nine months ended September 30, 2017 and September 30, 2016, (iii) the Condensed Consolidated Balance Sheet as of September 30, 2017 and December 31, 2016, (iv) the Condensed Consolidated Statement of Cash Flows for the nine months ended September 30, 2017 and September 30, 2016, and (vi) the Notes to the Condensed Consolidated Financial Statements.     
Exhibit
Number
Document Description
Stock and Asset Purchase Agreement, dated as of March 8, 2018, by and among the Company, MicroPort Cardiac Rhythm B.V. and MicroPort Scientific Corporation (excluding schedules and exhibits, which the Company agrees to furnish supplementally to the Securities and Exchange Commission upon request), incorporated by reference to Exhibit 2.1 of the Company’s Current Report on Form 8-K, filed on March 8, 2018
Amended Articles of Association, incorporated by reference to Exhibit 3.1 of the Company’s Current Report on Form 8-K, filed on June 15, 2018
2019 LivaNova Short-Term Incentive Plan approved February 20, 2019, incorporated by reference to Exhibit 10.1 of the Company’s Current Report on Form 8-K/A, filed on March 6, 2019
Commitment Letter dated February 25, 2019, by and among LivaNova PLC and the lenders party thereto
US$350 million multicurrency term facilities agreement dated March 26, 2019, by and among LivaNova PLC, the lenders, arrangers and bookrunners, documentation agent and co-ordinator parties thereto and Barclays Bank PLC as agent. Incorporated by reference to Exhibit 10.1 of the Company’s Current Report on Form 8-K, filed March 29, 2019
Description of 2019 Long Term Incentive Plan approved March 29, 2019, incorporated by reference to Exhibit 10.1 if the Company’s Current Report on Form 8-K, filed on April 1, 2019
Form of the Company’s 2019 Long Term Incentive Plan RSU Award Agreement, incorporated by reference to Exhibit 10.2 if the Company’s Current Report on Form 8-K, filed on April 1, 2019
Form of the Company’s 2019 Long Term Incentive Plan SAR Award Agreement, incorporated by reference to Exhibit 10.3 if the Company’s Current Report on Form 8-K, filed on April 1, 2019
Form of the Company’s 2019 Long Term Incentive Plan PSU Award Agreement (rTSR condition), incorporated by reference to Exhibit 10.4 if the Company’s Current Report on Form 8-K, filed on April 1, 2019
Form of the Company’s 2019 Long Term Incentive Plan PSU Award Agreement (FCF condition), incorporated by reference to Exhibit 10.5 of the Company’s Current Report on Form 8-K, filed on April 1, 2019
Service Agreement, dated February 28, 2017, between Alistair Simpson and LivaNova PLC
Certification of the Chief Executive Officer of LivaNova PLC pursuant to Section 302 of the Sarbanes-Oxley Act of 2002
Certification of the Chief Financial Officer of LivaNova PLC pursuant to Section 302 of the Sarbanes-Oxley Act of 2002
Certification of the Chief Executive Officer and Chief Financial Officer of LivaNova PLC pursuant to Section 906 of the Sarbanes-Oxley Act of 2002
101*Interactive Data Files Pursuant to Rule 405 of Regulation S-T: (i) the Condensed Consolidated Statements of Income (Loss) for the three months ended March 31, 2019 and March 31, 2018, (ii) the Condensed Consolidated Statements of Comprehensive Income for the three months ended March 31, 2019 and March 31, 2018, (iii) the Condensed Consolidated Balance Sheet as of March 31, 2019 and December 31, 2018, (iv) the Condensed Consolidated Statements of Cash Flows for the three months ended March 31, 2019 and March 31, 2018, and (vi) the Notes to the Condensed Consolidated Financial Statements.


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.
 
 LIVANOVA PLC
   
 By:/s/ DAMIEN MCDONALD
  Damien McDonald
  Chief Executive Officer
  (Principal Executive Officer)
 LIVANOVA PLC
   
 By:/s/ THAD HUSTON
  Thad Huston
  Chief Financial Officer
  (Principal Financial Officer)
Date: November 2, 2017May 1, 2019


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