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, 2017
or
¨
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d)
OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from _______________ to _______________
(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended: March 31, 2022
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
livn-20220331_g1.jpg
LivaNova PLC
(Exact name of registrant as specified in its charter)
England and Wales ...................98-1268150
(State or other jurisdiction of ..........(I.R.S. Employer
incorporation or organization) ........Identification No.)
20 Eastbourne Terrace, London, United Kingdom, W2 6LG
(Address of principal executive offices) .......................(Zip Code)
Registrant’s telephone number, including area code: (44) (0) 203 325-0660
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:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Ordinary Shares - £1.00 par value per shareLIVNThe NASDAQ Stock 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 þNo ¨
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 þNo ¨
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

¨
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, 2022
Ordinary Shares - £1.00 par value per share48,211,55953,440,615





LIVANOVA PLC
TABLE OF CONTENTS
PART I. FINANCIAL INFORMATIONPAGE 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™Neuromodulation systems, the VNS Therapy System, the VITARIA System and our proprietary pulse generator products: Model 102 (Pulse), Heartlink™Model 102R (Pulse Duo), Model 103 (Demipulse), Model 104 (Demipulse Duo), Model 106 (AspireSR), Model 1000 (SenTiva), Model 1000-D (SenTiva Duo), Model 7103 (VITARIA and Connect™TitrationAssist) and Model 8103 (Symmetry).
Trademarks for our line of surgical tissueCardiopulmonary products and mechanical valve replacementssystems: Essenz™, S5, S3, S5 Pro™, B-Capta, Inspire, Heartlink, XTRA, 3T Heater-Cooler, Connect™ 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™Revolution.
Trademarks for our implantable cardiac pacemakers and associated services: REPLY 200™, ESPRIT™, KORA 100™, KORA 250™, SafeR™, the REPLY CRT-P™, the remedé® System.
Trademarks for our Implantable Cardioverter Defibrillators and associated technologies: the INTENSIA™, PLATINIUM™, and PARADYM®product families.
Trademarks for our cardiac resynchronization therapy devices, technologies services: SonR®, SonRtip™, SonR CRT™, the INTENSIA™, PARADYM RF™, PARADYM 2™and PLATINIUM™ product families and the Respond CRT™ clinical trial.
Trademarks for heart failure treatment product: Equilia®.
Trademarks for our bradycardia leads: BEFLEX™ (active fixation)advanced circulatory support systems: TandemLife, TandemHeart, TandemLung, ProtekDuo™, LifeSPARC™, ALung™, Hemolung™, Respiratory Dialysis™ and XFINE™ (passive fixation)ActivMix™.
Trademarks for our obstructive sleep apnea system: ImThera and aura6000.
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 tradenamestrade names referred to in this Quarterly Report on Form 10-Q may appear without the ® or symbols, symbol, 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.trade names.



2



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:
Riskschanges in technology, including the development of superior or alternative technology or devices by competitors and/or competition from providers of alternative medical therapies;
risks related to our business:reductions, interruptions or increasing costs related to the supply of raw materials and components and the distribution of finished products, including as a result of inflation, war, etc.;
changes in our common stock price;failure to develop and commercialize new products and the rate and degree of market acceptance of such products;
changes in our profitability;
regulatory activities and announcements, including the failure to obtain approvals or maintain the current regulatory approvals for our new products;products’ approved indications;
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;
changes in customer spending patterns;
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;indications and risks related to cost containment efforts of healthcare purchasing organizations;
unfavorable results from clinical studies;studies or failure to meet milestones;
losses or costs from pending, or future lawsuits and governmental investigations, including any amount of liability or damages imposed by the Appeals Court or the Supreme Court of Italy with respect to SNIA S.p.A.;
risks relating to our indebtedness under the exchangeable senior notes, our revolving credit facility and our bridge loan facility;
volatility in the global market and worldwide economic conditions, including volatility caused by the invasion of Ukraine, changes to existing trade agreements and relationships between the U.S. and other countries including the implementation of sanctions and/or COVID-19;
effectiveness of our internal controls over financial reporting;
changes in our profitability and/or failure to manage costs and expenses;
fluctuations in future quarterly operating results and/or variations in sales and operating expenses relative to estimates;
cyber-attacks or other disruptions to our dependence on certain suppliers and manufacturers to provide certain materials, components and contract services necessary for the production of our products;information technology systems;
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;
3


failure to comply with applicable U.S. domestic laws and regulations, including federal and state privacy and security laws and regulations;
failure to comply withregulations, and applicable non-U.S. lawlaws and regulations;
non-U.S. operational and economic risks and concerns;
risks relating to the outbreak and spread of COVID-19 and its variants around the world;
failure to attract or retain key personnel;personnel, prevent labor shortages, or manage labor costs;

harsh weather or natural disasters, including as a result of climate change, that interrupt our business operations or the business operations of our hospital-customers or failure to comply with evolving environmental laws;

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;
changes in tax laws, including changes related to Brexit, or exposure to additional income tax liabilities;
harsh weather or natural disasters that interruptchanges in our business operations orcommon stock price; and
activist investors causing disruptions to the business operations of our hospital-customers; and
failure of the market to adopt new therapies or to adopt new therapies quickly.business.
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 and our other Quarterly ReportReports on Form 10-Q, (2) our Annual Report on Form 10-K for the fiscal year ended December 31, 20162021 (“20162021 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 our 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, 2022 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 20162021 Form 10-K.10-K and in our Quarterly Reports on Form 10-Q.
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.






4


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 March 31,
2022
2021 (1)
Net sales$240,175 $247,603 
Cost of sales71,732 84,195 
Gross profit168,443 163,408 
Operating expenses:
Selling, general and administrative118,525 115,681 
Research and development40,918 44,625 
Other operating expenses(505)8,800 
Operating income (loss)9,505 (5,698)
Interest expense(7,840)(15,936)
Foreign exchange and other gains/(losses)3,904 (6,443)
Income (loss) before tax5,569 (28,077)
Income tax expense2,537 2,644 
Losses from equity method investments(39)(40)
Net income (loss)$2,993 $(30,761)
Basic income (loss) per share$0.06 $(0.63)
Diluted income (loss) per share$0.06 $(0.63)
Shares used in computing basic income (loss) per share53,300 48,736 
Shares used in computing diluted income (loss) per share54,176 48,736 
(1)The condensed consolidated statement of income (loss) for the three months ended March 31, 2021 has been revised. For further details refer to “Note 1. Unaudited Condensed Consolidated Financial Statements.”
See accompanying notes to the condensed consolidated financial statements
5
  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




LIVANOVA PLC AND SUBSIDIARIES’SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OFCOMPREHENSIVE INCOME (LOSS)
(UNAUDITED)
(In thousands)
Three Months Ended March 31,
2022
2021 (1)
Net income (loss)$2,993 $(30,761)
Other comprehensive (loss) income:
Net change in unrealized loss on derivatives(695)(335)
Tax effect— 339 
Net of tax(695)
Foreign currency translation adjustment(8,260)(25,875)
Total other comprehensive loss(8,955)(25,871)
Total comprehensive loss$(5,962)$(56,632)
(1)The condensed consolidated statement of comprehensive income (loss) for the three months ended March 31, 2021 has been revised. For further details refer to “Note 1. Unaudited Condensed Consolidated Financial Statements.”
See accompanying notes to the condensed consolidated financial statements
6
  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)





LIVANOVA PLC AND SUBSIDIARIES’SUBSIDIARIES
CONDENSED CONSOLIDATEDBALANCE SHEETS
(UNAUDITED)
(In thousands, except share amounts)
 March 31, 2022December 31, 2021
ASSETS
Current Assets:
Cash and cash equivalents$128,737 $207,992 
Restricted cash313,647 — 
Accounts receivable, net of allowance of $13,493 at March 31, 2022 and $13,512 at December 31, 2021182,112 185,354 
Inventories114,844 105,840 
Prepaid and refundable taxes29,168 37,621 
Current derivative assets82 106,629 
Prepaid expenses and other current assets41,033 35,745 
Total Current Assets809,623 679,181 
Property, plant and equipment, net147,957 150,066 
Goodwill896,599 899,525 
Intangible assets, net390,455 399,682 
Operating lease assets38,167 40,600 
Investments16,745 16,598 
Deferred tax assets2,699 2,197 
Long-term derivative assets96,717 — 
Other assets17,921 13,102 
Total Assets$2,416,883 $2,200,951 
LIABILITIES AND STOCKHOLDERS' EQUITY
Current Liabilities:
Current debt obligations$4,752 $229,673 
Accounts payable73,921 68,000 
Accrued liabilities and other92,026 88,937 
Current derivative liabilities1,928 183,109 
Current litigation provision liability30,126 32,845 
Taxes payable22,592 15,140 
Accrued employee compensation and related benefits82,569 79,266 
Total Current Liabilities307,914 696,970 
Long-term debt obligations455,810 9,849 
Contingent consideration83,341 86,830 
Deferred tax liabilities7,879 7,728 
Long-term operating lease liabilities30,876 35,919 
Long-term employee compensation and related benefits18,779 19,105 
Long-term derivative liabilities170,660 — 
Other long-term liabilities49,770 49,905 
Total Liabilities1,125,029 906,306 
Commitments and contingencies (Note 7)00
Stockholders’ Equity:
Ordinary Shares, £1.00 par value: unlimited shares authorized; 53,763,500 shares issued and 53,435,821 shares outstanding at March 31, 2022; 53,761,510 shares issued and 53,263,297 shares outstanding at December 31, 202182,298 82,295 
Additional paid-in capital2,121,098 2,117,961 
Accumulated other comprehensive loss(16,132)(7,177)
Accumulated deficit(894,791)(897,784)
Treasury stock at cost, 327,679 ordinary shares at March 31, 2022; 498,213 ordinary shares at December 31, 2021(619)(650)
Total Stockholders’ Equity1,291,854 1,294,645 
Total Liabilities and Stockholders’ Equity$2,416,883 $2,200,951 
See accompanying notes to the condensed consolidated financial statements
7
  September 30, 2017 December 31, 2016
  (Unaudited)  
ASSETS    
Current Assets:    
Cash and cash equivalents $65,158
 $39,789
Accounts receivable, net 314,041
 275,730
Inventories 214,593
 183,489
Prepaid and refundable taxes 58,969
 60,615
Assets held for sale 14,117
 4,477
Prepaid expenses and other current assets 55,176
 55,973
Total Current Assets 722,054
 620,073
Property, plant and equipment, net 213,769
 223,842
Goodwill 781,070
 691,712
Intangible assets, net 717,646
 609,197
Investments 46,380
 61,092
Deferred tax assets, net 4,356
 6,017
Other assets 117,855
 130,698
Total Assets $2,603,130
 $2,342,631
LIABILITIES AND STOCKHOLDERS' EQUITY    
Current Liabilities:    
Current debt obligations $52,074
 $47,650
Accounts payable 102,651
 92,952
Accrued liabilities and other 92,212
 75,567
Taxes payable 28,954
 22,340
Accrued employee compensation and related benefits 80,466
 78,302
Total Current Liabilities 356,357
 316,811
Long-term debt obligations 71,853
 75,215
Deferred income taxes liability 152,133
 172,541
Long-term employee compensation and related benefits 33,957
 31,668
Other long-term liabilities 74,404
 39,487
Total Liabilities 688,704
 635,722
Commitments and contingencies (Note 9) 
 
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
Additional paid-in capital 1,731,565
 1,719,893
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)
Total Stockholders’ Equity 1,914,426
 1,706,909
Total Liabilities and Stockholders’ Equity $2,603,130
 $2,342,631




LIVANOVA PLC AND SUBSIDIARIES’SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OFCASH FLOWS
(UNAUDITED)
(In thousands)
Three Months Ended March 31,
2022
2021 (1)
Operating Activities:
Net income (loss)$2,993 $(30,761)
Non-cash items included in net income (loss):
Stock-based compensation10,256 9,536 
Amortization6,465 6,699 
Depreciation5,626 6,079 
Amortization of debt issuance costs4,412 4,409 
Remeasurement of contingent consideration to fair value(3,773)453 
Amortization of operating lease assets2,653 5,389 
Remeasurement of Respicardia investment and loan— (4,640)
Remeasurement of derivative instruments(1,355)7,268 
Other1,073 498 
Changes in operating assets and liabilities:
Accounts receivable, net1,494 (3,372)
Inventories(9,637)(1,625)
Other current and non-current assets(1,953)26,820 
Accounts payable and accrued current and non-current liabilities9,957 (1,858)
Taxes payable709 (3,337)
Litigation provision liability(3,097)(2,078)
Net cash provided by operating activities25,823 19,480 
Investing Activities:
Purchases of property, plant and equipment(5,215)(8,220)
Purchase of investments(278)(1,800)
Proceeds from asset sales11 162 
Net cash used in investing activities(5,482)(9,858)
Financing Activities:
Proceeds from long-term debt obligations218,342 — 
Payment of debt issuance costs(2,426)— 
Shares repurchased from employees for minimum tax withholding(1,074)(3,740)
Payment of contingent consideration— (4,387)
Other35 (201)
Net cash provided by (used in) financing activities214,877 (8,328)
Effect of exchange rate changes on cash, cash equivalents and restricted cash(826)(1,587)
Net increase (decrease) in cash, cash equivalents and restricted cash234,392 (293)
Cash, cash equivalents and restricted cash at beginning of period207,992 252,832 
Cash, cash equivalents and restricted cash at end of period$442,384 $252,539 
(1)The condensed consolidated statement of cash flows for the three months ended March 31, 2021 has been revised. For further details refer to “Note 1. Unaudited Condensed Consolidated Financial Statements.”
See accompanying notes to the condensed consolidated financial statements
8
  Nine Months Ended September 30,
  2017 2016
Operating Activities:  
  
Net income (loss) $86,599
 $(32,990)
Non-cash items included in net income (loss):    
Depreciation 27,880
 30,193
Amortization 35,445
 33,959
Stock-based compensation 14,261
 15,575
Deferred income tax benefit (27,270) (10,224)
Losses from equity method investments 20,072
 19,382
Gain on acquisition of Caisson Interventional, LLC (39,428) 
Impairment of property, plant and equipment 4,581
 
Amortization of income taxes payable on inter-company transfers of property 23,831
 17,114
Other 3,364
 8,765
Changes in operating assets and liabilities:    
Accounts receivable, net (19,107) (11,040)
Inventories (11,006) 20,607
Other current and non-current assets (17,846) (25,845)
Restructuring reserve (12,753) 14,961
Accounts payable and accrued current and non-current liabilities (14,958) (31,109)
Net cash provided by operating activities 73,665
 49,348
Investing Activities:  
  
Purchases of property, plant and equipment and other (24,004) (28,928)
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
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)
Financing Activities:    
Change in short-term borrowing, net (18,054) (33,831)
Proceeds from short-term borrowing (maturities greater than 90 days) 20,000
 
Repayment of long-term debt obligations (11,615) (11,354)
Proceeds from exercise of stock options 3,221
 7,888
Repayment of trade receivable advances 
 (23,848)
Proceeds from long-term debt obligations 
 7,994
Share repurchases 
 (11,053)
Other (3,552) 1,208
Net cash used in financing activities (10,000) (62,996)
Effect of exchange rate changes on cash and cash equivalents 3,501
 1,030
Net increase (decrease) in cash and cash equivalents 25,369
 (48,981)
Cash and cash equivalents at beginning of period 39,789
 112,613
Cash and cash equivalents at end of period $65,158
 $63,632




LIVANOVA PLC AND SUBSIDIARIES
NOTESTO 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, 2017 and September 30, 2016,March 31, 2022, 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, 20162021 has been derived from audited financial statements contained in our 20162021 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 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, 2022, and are not necessarily indicative of the results that may be expected for the year ending December 31, 2017.2022. The financial information presented herein should be read in conjunction with the audited consolidated financial statements and notes thereto accompanying our 20162021 Form 10-K.
DescriptionGlobal Developments
COVID-19
The COVID-19 pandemic (“COVID-19”) has caused and may continue to cause unpredictable demand for our products. Throughout the pandemic, healthcare customers have diverted medical resources and priorities towards the treatment of COVID-19, and public health bodies have delayed elective procedures, which has negatively impacted the usage of our products. Further, some people have avoided seeking treatment for non-COVID-19 procedures, and hospitals and clinics have experienced staffing shortages, which has negatively impacted the demand for our products. While the recent recovery of global cardiopulmonary procedures has resulted in stronger demand for our Cardiopulmonary products, our Neuromodulation and Advanced Circulatory Support businesses continue to experience ongoing COVID-19 related headwinds. We are monitoring the potential for various strains of the Mergersvirus to cause a resumption of high levels of infection and hospitalization that, in turn, may affect the demand for our products.
On October 19, 2015 LivaNova becameMoreover, although our RECOVER study and ANTHEM-HFrEF pivotal trial continue to progress, there may be delays or closures of sites in the holding companyfuture should COVID-19 or variants thereof strengthen or reemerge.
Certain conditions improved during 2021, but we continue to experience COVID-19 related headwinds. Like many companies, for example, we are experiencing supply chain delays and interruptions, labor shortages, inflationary pressures and logistical issues in the wake of COVID-19. Though, to date, our supply of raw materials and the production and distribution of finished products have not been materially affected, demand and low capacity worldwide have caused longer lead times and put price pressure on key raw materials. Moreover, freight and labor costs at our manufacturing facilities have increased in the wake of inflation globally. The Company continues to respond to such challenges, and while we have business continuity plans in place, the impact of the combined businessesongoing challenges we are experiencing, along with their potential escalation, may adversely affect our business and the recoverability of Cyberonics, Inc. (“Cyberonics”)our tangible and Sorin S.p.A. (“Sorin”) (the “Mergers”). Based onintangible assets. The future impact of pandemic-related developments remains uncertain.
Ukraine Invasion
In February 2022, Russia launched an invasion in Ukraine which caused us to assess our ability to sell in the structuremarket due to international sanctions, to consider the potential impact of raw material sourced from the region, and to determine whether we are able to transact in a compliant fashion. Although the region represented 1% of our total net sales for 2021, the Russian invasion of Ukraine has increased economic uncertainties, and a significant escalation or continuation of the Mergers, management determined that Cyberonics was consideredconflict could have a material, global impact on our operating results. In addition, our Russian employees and local subsidiary are subject to beevolving laws and regulations imposed by the accounting acquirerRussian authorities in response to international sanctions.
9


Revision of Previously Issued Financial Statements
During the fourth quarter of 2021, the Company identified and predecessor for accounting purposes.
Reclassificationcorrected an error related to foreign currency exchange rates utilized to calculate inventory and cost of Prior-Year Comparative Period Presentation
To conform the condensed consolidated statement of income (loss)sales for the three and nine monthsyears 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 Expenses2017 through 2020 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, 2017.2021. Using the guidance in ASC Topic 250, Accounting Changes and Error Corrections, ASC Topic 250-S99-1, Assessing Materiality, and ASC Topic 250-S99-2, Considering the Effects of Prior Year Misstatements when Quantifying Misstatements in Current Year Financial Statements, we evaluated whether our previously issued consolidated financial statements were materially misstated due to these errors. Based upon our evaluation of both quantitative and qualitative factors, we believe that the effects of these errors were not material individually or in the aggregate to any previously reported quarterly or annual period. Accordingly, we have revised our previously issued financial statements as shown below (in thousands):
To conformConsolidated Statements of Income (Loss)
Three Months Ended March 31, 2021
As Previously ReportedAdjustmentsAs Revised
Cost of sales - exclusive of amortization$79,216 $1,275 $80,491 
Operating loss(4,423)(1,275)(5,698)
Loss before tax(26,802)(1,275)(28,077)
Income tax expense2,856 (212)2,644 
Net loss(29,698)(1,063)(30,761)
Basic and diluted loss per share$(0.61)$(0.02)$(0.63)
Consolidated Statements of Comprehensive Income (Loss)
Three Months Ended March 31, 2021
As Previously ReportedAdjustmentsAs Revised
Net loss$(29,698)$(1,063)$(30,761)
Total comprehensive loss(55,569)(1,063)(56,632)
Consolidated Statements of Stockholders’ Equity
As Previously ReportedAdjustmentsAs Revised
Accumulated DeficitTotal Stockholders’ EquityAccumulated DeficitTotal Stockholders’ EquityAccumulated DeficitTotal Stockholders’ Equity
March 31, 2021$(782,100)$1,065,757 $(10,627)$(10,627)$(792,727)$1,055,130 
Consolidated Statements of Cash Flows
Three Months Ended March 31, 2021
As Previously ReportedAdjustmentsAs Revised
Net loss$(29,698)$(1,063)$(30,761)
Deferred tax expense (benefit)37 (212)(175)
Changes in operating assets and liabilities:
Inventories(2,900)1,275 (1,625)
Net cash used in operating activities19,480 — 19,480 
Reclassifications
We have reclassified certain prior period amounts on the condensed consolidated statementstatements of income (loss), the condensed consolidated balance sheets and the condensed consolidated statements of cash flows for the nine months ended September 30, 2016 to the currentcomparative purposes. These reclassifications did not have a material effect on our financial condition, results of operations or cash flows. The prior 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 conformreclassifications on the condensed consolidated statementstatements of cash flows forincome (loss) are summarized and presented below (in thousands):
Product remediation has been reclassified to cost of sales;
10


Merger and integration expenses have been reclassified to other operating expenses;
Restructuring expenses have been reclassified to other operating expenses;
Litigation provision, net has been reclassified to other operating expenses;
Amortization of intangibles has been reclassified to cost of sales or selling, general and administrative based on the nine months ended September 30, 2016 tonature of the current period presentation, Loans to Equity and Cost Method Investeesunderlying intangible asset;
Gain on the sale of $6.6 million wereHeart Valve business has been reclassified from Financing Activitiesrevaluation of disposal group to Investing Activities.other operating expenses; and
Interest income has been reclassified to foreign exchange and other gains/(losses).
Three Months Ended March 31, 2021
As RevisedReclassificationsCurrent Presentation
Net sales$247,603 $— $247,603 
Cost of sales80,491 3,704 84,195 
Product remediation68 (68)— 
Gross profit167,044 (3,636)163,408 
Operating expenses:
Selling, general and administrative112,618 3,063 115,681 
Research and development44,625 — 44,625 
Merger and integration expenses630 (630)— 
Restructuring expenses6,092 (6,092)— 
Revaluation of disposal group(966)966 — 
Amortization of intangibles6,699 (6,699)— 
Litigation provision, net3,044 (3,044)— 
Other operating expenses— 8,800 8,800 
Operating loss(5,698)— (5,698)
Interest income(74)74 — 
Interest expense(15,936)— (15,936)
Foreign exchange and other gains/(losses)(6,369)(74)(6,443)
Loss before tax$(28,077)$— $(28,077)
Significant Accounting Policies
Our significant accounting policies are detailed below and in "Note 2:“Note 2. Basis of Presentation, Use of Accounting Estimates and Significant Accounting Policies"Policies” and “Note 3. Revenue Recognition” of our 20162021 Form 10-K. A further explanation of our Foreign Currency accounting policy is discussed below:
Foreign CurrencyRestricted Cash
Our functional currency is the U.S. dollar, however, a portion of 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,The Company classifies cash that is the currency of the environmentnot available for use 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.



Assets and liabilities for subsidiaries whose functional currency is not the U.S. dollar are translated into U.S. dollars based on a combination of bothits operations as restricted cash within current and historical exchange rates, while their revenues earned 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”) in the condensed consolidated balance sheets. Gains and losses arising from transactions denominated in 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).
Note 2. Acquisitions
In support of our strategic growth initiatives, on May 2, 2017, we acquired the remaining 51% equity interests in Caisson Interventional, LLC (“Caisson”) 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 contingent consideration of up to $39.6 million to be paid on a schedule driven primarily by regulatory approvals 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-value of the consideration transferred and the fair value of our interest in Caisson 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
(1)
Concurrent with the acquisition, we recognized $5.8 million of post-combination compensation expense. Of this amount, $2.4 million is reflected 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.
(2)On the acquisition date, we remeasured the notes receivable from Caisson and our existing investment in Caisson at fair value and recognized a pre-tax non-cash gain of $1.3 million and $38.1 million, respectively, which are included in ‘Gain on acquisition of Caisson Interventional, LLC’ in the condensed consolidated statements of income (loss).
The following table presents the preliminary purchase price allocation at fair value for the Caisson 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 million is expected to be deductible for tax purposes. Additionally, $3.0 million of the initial cash payment was deposited in escrow for future claims indemnification. Of this amount, $2.0 million is included in ‘Prepaid expenses and other current assets’ and the remaining $1.0 million is included in ‘Other long-term assets’assets on the condensed consolidated balance sheetsheet. As of March 31, 2022, our restricted cash balance totaled $313.6 million and was comprised of cash deposits with Barclays held as collateral for a first demand bank guarantee of €270.0 million (approximately $299.5 million as of September 30, 2017.March 31, 2022) to obtain the suspension of the Court of Appeal of Milan judgment for the payment of damages in connection with the SNIA litigation until review of such judgment by the Italian Supreme Court (the “SNIA Litigation Guarantee”). As security for the SNIA Litigation Guarantee, LivaNova is required to grant cash collateral to Barclays in US dollars in an amount equal to the USD equivalent of 105% of the amount of the SNIA Litigation Guarantee calibrated on a biweekly basis. For additional information regarding the SNIA litigation, please refer to “Note 7. Commitments and Contingencies.”
11


Note 2. Divestiture of Heart Valve Business
On December 2, 2020, LivaNova entered into a Purchase Agreement with Mitral Holdco S.à r.l., a company incorporated under the laws of Luxembourg and wholly-owned and controlled by funds advised by Gyrus Capital S.A., a Swiss private equity firm. The Purchase Agreement provides for the divestiture of certain of LivaNova’s subsidiaries as well as certain other assets and liabilities relating to the Company’s Heart Valve business and site management operations conducted by the Company’s subsidiary LivaNova Site Management (“LSM”) at the Company’s Saluggia campus for €60.0 million. On April 9, 2021, LivaNova and the Purchaser entered into an A&R Purchase Agreement which amends and restates the original Purchase Agreement to, among other things, defer the closing of the sale and purchase of LSM by up to two years and include or amend certain additional terms relating to such deferral, including certain amendments relating to the potential hazardous substances liabilities of LSM and the related expense reimbursement provisions.
The closing of the sale of the Heart Valve business occurred on June 1, 2021, and we received €34.8 million (approximately $42.5 million as of June 1, 2021), subject to customary trade working capital and net indebtedness adjustments, as set forth in the Purchase Agreement. We recognized acquisition-related expensesalso received $3.0 million in December 2021. An additional €9.3 million (approximately $10.3 million as of approximatelyMarch 31, 2022) is payable to LivaNova in 2022. During the three months ended March 31, 2021, we increased the carrying value of the disposal group by $1.0 million, for legal and valuation expenses during the nine months ended September 30, 2017. These expenses arewhich is included within ‘Selling, general and administrative’other operating expenses inon 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).


The contingent consideration arrangements are composed of potential cash payments upon the achievement of certain regulatory milestones 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. 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
      
The following table provides a reconciliation of the beginning and ending balance of the contingent consideration liability, which consisted of arrangements that arose from the Caisson acquisition and other previous acquisitions that also included contingent consideration (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
(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. The third acquisition, Caisson, occurred in May 2017 and is discussed above. Refer to “Note 6. Fair Value Measurements.”
Note 3. RestructuringInvestments
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 these 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’ in our operating results in the condensed consolidated statements of income (loss). We estimate that the Plans will result in a net reduction of 326 personnel 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,Investments on the condensed consolidated balance sheet.


The following table presents restructuring expense accrual detail (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
The following table presents restructuring expense by reportable segment (in thousands):
  Three Months Ended September 30, Nine Months Ended September 30,
  2017 2016 2017 2016
Cardiac Surgery $441
 $916
 $6,944
 $5,878
Cardiac Rhythm Management (391) 571
 (1,750) 16,592
Neuromodulation 14
 2,882
 513
 7,017
Other 728
 12
 6,353
 7,732
Total $792
 $4,381
 $12,060
 $37,219
Note 4. Product Remediation Liability
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. 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. 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 and sealing upgrade on a customer-owned device. We are currently implementing the vacuum and sealing upgrade program in as many countries as possible throughout the remainder of 2017. As part of the remediation plan, we also intend to perform a no-charge deep disinfection 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, 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
Adjustments (15)
Remediation activity (5,672)
Effect of changes in foreign currency exchange rates 2,446
Balance at September 30, 2017 (1)
 $30,246
(1)
At September 30, 2017, the product remediation liability balance is held within ‘Accrued liabilities and other’ and ‘Other long-term liabilities’ on the condensed consolidated balance sheet. Refer to “Note 15. Supplemental Financial Information.”
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. We recognize changes in estimates on a prospective basis. At this stage, no liability has


been recognized with respect to any lawsuits involving us related to the 3T device, while related legal costs are expensed as incurred. For further information, please refer to “Note 9. Commitments and Contingencies - 3T Heater-Cooler Devices.”
Note 5. Investments
Cost-Method Investments
Our cost-method investments are included in ‘Investments’ in 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
Respicardia Inc. (1)
 $21,129
 $17,518
ImThera Medical, Inc. (2)
 12,000
 12,000
Rainbow Medical Ltd. (3)
 4,178
 3,733
MD Start II 1,179
 526
Other (4)
 150
 
  $38,636
 $33,777
(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 million, as of September 30, 2017, which is included in ‘Prepaid expenses and other current assets’ on 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 thatrepresent the carrying value of our aggregateinvestments 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 might not be recoverableof the same issuer. At March 31, 2022 and thatDecember 31, 2021, 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 notesinvestments was $16.7 million and $16.6 million, respectively.
In April 2021, Zoll Medical Corporation acquired Respicardia Inc., a privately funded U.S. company in which we had an equity investment and also to which we had a loan outstanding. As a result of the acquisition, we received proceeds of $23.1 million for both our investment and loan receivable from Highlife at September 30, 2017 waswhich had carrying values of $17.7 million and $0.8 million as of December 31, 2020, respectively. The Company recorded a gain of $4.6 million during the first quarter of 2021 to adjust the investment and loans receivable to fair value, which is included in ‘Other assets’foreign exchange and other gains/(losses) on the condensed consolidated balance sheet.statement of income (loss).
Note 6.4. 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, 2022 and 2021.
12


Assets and Liabilities Measured at Fair Value on a Recurring Basis
The following table providestables provide information by level for assets and liabilities that are measured at fair value on a recurring basis (in thousands):
Fair Value as of March 31, 2022Fair Value Measurements Using Inputs Considered as:
Level 1Level 2Level 3
Assets:
Derivative assets - designated as cash flow hedges (foreign currency exchange rate “FX”)$262 $��� $262 $— 
Derivative assets - freestanding instruments (FX)21 — 21 — 
Derivative assets - capped call derivatives96,717 — — 96,717 
Convertible notes receivable2,770 — — 2,770 
$99,770 $— $283 $99,487 
Liabilities:
Derivative liabilities - designated as cash flow hedges (FX)$1,946 $— $1,946 $— 
Derivative liabilities - freestanding instruments (FX)183 — 183 — 
Derivative liabilities - embedded exchange feature170,660 — — 170,660 
Contingent consideration arrangements94,609 — — 94,609 
$267,398 $— $2,129 $265,269 

Fair Value as of December 31, 2021
Fair Value Measurements Using Inputs Considered as:
Level 1Level 2Level 3
Assets:
Derivative assets - designated as cash flow hedges (foreign currency exchange rate FX)
$243 $— $243 $— 
Derivative assets - freestanding instruments (FX)61 — 61 — 
Derivative assets - capped call derivatives106,629 — — 106,629 
Convertible notes receivable2,767 — — 2,767 
$109,700 $— $304 $109,396 
Liabilities:
Derivative liabilities - designated as cash flow hedges (FX)$1,286 $— $1,286 $— 
Derivative liabilities - freestanding instruments (FX)427 — 427 — 
Derivative liabilities - embedded exchange feature181,700 — — 181,700 
Contingent consideration arrangements98,382 — — 98,382 
$281,795 $— $1,713 $280,082 
13


  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
 Fair Value Measurements Using Inputs Considered as:
  December 31, 2016 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
 
  $8,269
 $
 $8,269
 $
         
Liabilities:        
Derivative liabilities - designated as cash flow hedges (FX) $942
 $
 $942
 $
Derivative liabilities - designated as cash flow hedges (interest rate swaps) 1,392
 
 1,392
 
Contingent consideration 3,890
 
 
 3,890

 $6,224
 $
 $2,334
 $3,890
OurThe following table provides a reconciliation of the beginning and ending balances of our recurring fair value measurements, using significant unobservable inputs (level(Level 3), relate solely to our contingent consideration liability. Refer (in thousands):
Capped Call Derivative AssetConvertible Notes ReceivableEmbedded Exchange Feature Derivative LiabilityContingent Consideration Liability Arrangements
As of December 31, 2021$106,629 $2,767 $181,700 $98,382 
Changes in fair value(9,912)(11,040)(3,773)
Total at March 31, 202296,717 2,770 170,660 94,609 
Less current portion at March 31, 2022— 2,495 — 11,268 
Long-term portion at March 31, 2022$96,717 $275 $170,660 $83,341 
Embedded Exchange Feature and Capped Call Derivatives
In June 2020, the Company issued $287.5 million in cash exchangeable senior notes and entered into related capped call transactions. The cash exchangeable senior notes include an embedded exchange feature that is bifurcated from the cash exchangeable senior notes. Please refer to “Note 2. Acquisitions”5. Financing Arrangements” for further details. The embedded exchange feature derivative is measured at fair value using a discussionbinomial lattice model and discounted cash flows that utilize observable and unobservable market data. The capped call derivative is measured at fair value using the Black-Scholes model utilizing observable and unobservable market data, including stock price, remaining contractual term, expected volatility, risk-free interest rate and expected dividend yield, as applicable.
The embedded exchange feature and capped call derivatives are classified as Level 3 as the Company uses historical volatility and implied volatility from options traded to determine expected stock price volatility which is an unobservable input that is significant to the valuation. In general, an increase in our stock price or stock price volatility would increase the fair value of the changesembedded exchange feature and capped call derivatives which would result in an increase in expense. As time to the expiration of the derivatives decreases, the fair value of the derivatives would decrease. The future impact on net income depends on how significant inputs such as stock price, stock price volatility and time to the expiration of the derivatives change in relation to other inputs. Changes in the fair value of the embedded exchange feature derivative and capped call derivatives are recognized in foreign exchange and other gains/(losses) in the condensed consolidated statements of income (loss).
The stock price volatility as of March 31, 2022 was 36%. As of March 31, 2022, a 10% lower volatility, holding other inputs constant, would result in approximate fair value for the embedded exchange feature derivative of $154.5 million and a 10% higher volatility, holding other inputs constant, would result in approximate fair value of $188.2 million. As of March 31, 2022, a 10% lower volatility, holding other inputs constant, would result in approximate fair value for the capped call derivatives of $107.4 million and a 10% higher volatility, holding other inputs constant, would result in approximate fair value of $87.4 million.
14


Contingent Consideration Arrangements
The following table provides the fair value of our Level 3 contingent consideration liability.

arrangements by acquisition (in thousands):

March 31, 2022December 31, 2021
ImThera$83,341 $86,830 
TandemLife11,268 11,552 
$94,609 $98,382 
The ImThera business combination involved contingent consideration arrangements composed of potential cash payments upon the achievement of a certain regulatory milestone and a sales-based earnout associated with sales of products. The sales-based earnout is valued using projected sales from our internal strategic plan. Both arrangements are Level 3 fair value measurements and include the following significant unobservable inputs as of March 31, 2022:
ImThera AcquisitionValuation TechniqueUnobservable InputInputs
Regulatory milestone-based paymentDiscounted cash flowDiscount rate5.3%
Probability of payment85%
Projected payment year2024
Sales-based earnoutMonte Carlo simulationRisk-adjusted discount rate13.9%
Credit risk discount rate5.5% -6.2%
Revenue volatility32.5%
Probability of payment85%
Projected years of earnout2025-2028
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 as of March 31, 2022:
TandemLife AcquisitionValuation TechniqueUnobservable InputInputs
Regulatory milestone-based paymentDiscounted cash flowDiscount rate4.9%
Probability of payment90%
Projected payment year2023
15


Note 7.5. Financing Arrangements
The outstanding principal amount of our long-term debt as of March 31, 2022 and December 31, 2021 was as follows (in thousands, except interest rates):
March 31, 2022December 31, 2021MaturityInterest Rate
2020 Cash Exchangeable Senior Notes$228,535 $225,140 December 20253.00%
Bridge Loan Facility216,366 — June 20234.17%
Bank of America Merrill Lynch Banco Múltiplo S.A.7,203 6,113 July 20239.32%
Mediocredito Italiano3,312 3,379 December 20230.50%-2.74%
Bank of America, U.S.1,500 1,500 January 20232.85%
Other623 663 
Total long-term facilities457,539 236,795 
Less current portion of long-term debt1,729 226,946 
Total long-term debt$455,810 $9,849 
  September 30, 2017 December 31, 2016 Maturity Interest Rate
European Investment Bank (1)
 $78,590
 $78,987
 June 2021 0.95%
Mediocredito Italiano (3)
 7,719
 7,276
 December 2023 0.50% - 3.07%
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%
Region Wallonne 831
 798
 December 2023 and June 2033 0.00% - 2.45%
Mediocredito Italiano - mortgages and other 742
 799
 September 2021 and September 2026 0.40% - 0.65%
Total debt 95,975
 96,516
    
Less current portion of long-term debt 24,122
 21,301
    
Total long-term debt $71,853
 $75,215
    
(1)The European Investment Bank (“EIB”) loan was obtained in July 2014 to support product development projects. The interest rate for the 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.
Revolving Credit
The outstanding principal amount of our short-term unsecured revolving credit agreements and other agreements with various banks was $28.0$3.0 million and $26.4$2.7 million at September 30, 2017March 31, 2022 and December 31, 2016,2021, respectively, with interest rates ranging from 0.2%2.85% to 10.5%9.32% and loan terms ranging from one dayovernight to 365 days.364 days, as of March 31, 2022.
European InvestmentOn August 13, 2021, LivaNova PLC and its wholly-owned subsidiary, LivaNova USA, Inc. (the “Borrower”) entered into a First Lien Credit Agreement with the lenders and issuing banks party thereto and Goldman Sachs Bank USA, as First Lien Administrative Agent and First Lien Collateral Agent, relating to a $125 million senior secured multi-currency revolving credit facility to be made available to the Borrower (the “2021 Revolving Credit Facility”). The 2021 Revolving Credit Facility, as amended on March 16, 2022, expires on August 13, 2026 and bears interest at a rate equal to, for U.S. dollar-denominated loans, an adjusted Secured Overnight Financing Rate (“SOFR”) with a floor of 0.00%, or a Base Rate, plus, in each case, a variable margin based on the Company’s senior secured net leverage ratio. Interest is paid monthly or quarterly, as selected by the Borrower, with any outstanding principal due at maturity. The First Lien Credit Agreement also contemplates the payment of commitment fees on the unused portion of the commitments, at a variable percentage based on the Company’s senior secured net leverage ratio. The 2021 Revolving Credit Facility is available for working capital and other general corporate purposes and, if drawn, can be repaid at any time without premium or penalty. The First Lien Credit Agreement contains customary representations, warranties and covenants, including the requirement to maintain a senior secured first lien net leverage ratio of less than 4.50 to 1.00 for as long as there are any revolving loans outstanding under the 2021 Revolving Credit Facility, as well as in order for the Company to borrow additional revolving loans.
There were no outstanding borrowings under the 2021 Revolving Credit Facility as of March 31, 2022 and December 31, 2021.
Bridge Loan Facility
On February 24, 2022, LivaNova PLC and its wholly-owned subsidiary, LivaNova USA, Inc., entered into an Incremental Facility Amendment No. 1 to the 2021 Revolving Credit Facility, relating to a €200 million bridge loan facility (the “Bridge Loan Facility”). On March 16, 2022, LivaNova entered into Amendment No. 2 to the 2021 Revolving Credit Facility, which converted the available borrowings under the Bridge Loan Facility from €200 million to $220.0 million and converted the EURIBOR rate in the 2021 Revolving Credit Facility to SOFR. LivaNova delivered a borrowing notice for $220.0 million in connection with the Bridge Loan Facility, which was funded on March 17, 2022. On March 18, 2022, LivaNova PLC, acting through its Italian branch, entered into an Indemnity Letter and an Account Pledge Agreement with Barclays, further to which Barclays issued the SNIA Litigation Guarantee. As security for the SNIA Litigation Guarantee, LivaNova is required to grant cash collateral to Barclays in US dollars in an amount equal to the USD equivalent of 105% of the amount of the SNIA Litigation Guarantee calibrated on a biweekly basis. The proceeds of the Bridge Loan Facility were used by LivaNova to post a portion of the cash collateral supporting the SNIA Litigation Guarantee and can be used towards payment of court ordered damages or settlements (including interest, expenses and charges in connection therewith) in the event of a negative decision by the Italian Supreme Court. The cash held as collateral supporting the SNIA Litigation Guarantee of $313.6 million is classified as restricted cash on the condensed consolidated balance sheet as of March 31, 2022. The Bridge Loan Facility bears interest at an adjusted term SOFR, with a floor of 0.5%, plus 3.5% increasing by 0.25% 15 days after drawing and by an additional 0.5%
16


90 days after drawing and every 90 days thereafter, with a maximum margin of 5.25% over adjusted SOFR. The effective interest rate of the Bridge Loan Facility at March 31, 2022 was 11.04%. The Bridge Loan Facility matures on June 16, 2023 and is subject to mandatory prepayment in connection with certain asset dispositions, equity or debt issuance as well as in the event that collateral securing the SNIA Litigation Guarantee is released. For additional information regarding the SNIA litigation, please refer to “Note 7. Commitments and Contingencies.”
Debt discounts and issuance costs related to the Bridge Loan Facility were approximately $4.5 million. Amortization of debt discount and issuance costs for the Bridge Loan Facility was $0.9 million for the three months ended March 31, 2022 and is included in interest expense on the consolidated statement of income (loss). The unamortized discount related to the Bridge Loan Facility as of March 31, 2022 was $3.6 million.
Outstanding borrowings under the Bridge Loan Facility was $220.0 million as of March 31, 2022.
2020 Cash Exchangeable Senior Notes
On June 29, 2017,17, 2020, our wholly-owned subsidiary, LivaNova USA, Inc., issued $287.5 million aggregate principal amount of 3.00% Notes (the “Notes”) by private placement to qualified institutional buyers pursuant to Rule 144A under the Securities Act of 1933, as amended. The sale of the Notes resulted in approximately $278.0 million in net proceeds to the Company after deducting issuance costs. Interest is payable semiannually in arrears on June 15 and December 15 of each year, beginning on December 15, 2020. The effective interest rate of the Notes at March 31, 2022 was 9.95%. The Notes mature on December 15, 2025 unless earlier exchanged, repurchased, or redeemed.
Debt discounts and issuance costs related to the Notes were approximately $82.0 million and included $75.0 million of discount attributable to the embedded exchange feature, discussed below, and $7.0 million of allocated issuance costs to the Notes related to legal, bank and accounting fees. Amortization of debt discount and issuance costs for the Notes was $3.4 million and $3.1 million for the three months ended March 31, 2022 and 2021, respectively, and is included in interest expense on the consolidated statement of income (loss). The unamortized discount related to the Notes as of March 31, 2022 and December 31, 2021 was $59.0 million and $62.4 million, respectively.
Holders of the Notes are entitled to exchange the Notes at any time during specified periods, at their option. This includes the right to exchange the Notes during any calendar quarter, if the last reported sale price of LivaNova’s ordinary shares, with a nominal value of £1.00 per share, is greater than or equal to 130% of the exchange price, or $79.27 per share for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on, and including, the last trading day of the immediately preceding calendar quarter. The exchange condition was not satisfied during the quarterly period ending March 31, 2022. As a result, we have included our obligations from the Notes and the associated embedded exchange feature derivative as a long-term liability on the consolidated balance sheet as of March 31, 2022. The Notes are exchangeable solely into cash and are not exchangeable into ordinary shares of LivaNova or any other security under any circumstances. The initial exchange rate for the Notes is 16.3980 ordinary shares per $1,000 principal amount of Notes (equivalent to an initial exchange price of approximately $60.98 per share). The exchange rate is subject to adjustment in certain circumstances, as set forth in the indenture governing the Notes.
The Company may redeem the Notes at its option, on or after June 20, 2023 and prior to the 51st scheduled trading day immediately preceding the maturity date, in whole or in part, if the last reported sale price per ordinary share has been at least 130% of the exchange price then in effect for at least 20 trading days (whether or not consecutive), including the trading day immediately preceding the date on which the Company provides notice of redemption, during any 30 consecutive trading day period ending on, and including, the trading day immediately preceding the date on which the Company provides notice of redemption, at a redemption price equal to 100% of the principal amount of the Notes to be redeemed, plus accrued and unpaid interest to, but excluding, the redemption date. Additionally, the Company may redeem the Notes at its option, prior to their stated maturity, in whole but not in part, in connection with certain tax-related events.
Embedded Exchange Feature
The embedded exchange feature of the Notes requires bifurcation from the Notes and is accounted for as a derivative liability. The fair value of the Notes’ embedded exchange feature derivative at the time of issuance was $75.0 million and was recorded as debt discount on the Notes. This discount is amortized as interest expense using the effective interest method over the term of the Notes. The Notes’ embedded exchange feature derivative is carried on the condensed consolidated balance sheets at its estimated fair value and is adjusted at the end of each reporting period, with the unrealized gain or loss reflected within foreign exchange and other gains/(losses) in the condensed consolidated statements of income (loss). The fair value of the embedded exchange feature derivative liability was $170.7 million as of March 31, 2022.
17


Capped Call Transactions
In connection with the pricing of the Notes, the Company entered into a new finance contract (the “Finance Contract”)privately negotiated capped call transactions 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. Loansinitial purchasers of the Notes or their respective affiliates. The capped call transactions cover, subject to anti-dilution adjustments substantially similar to those applicable to the Notes, the number of LivaNova’s ordinary shares underlying the Notes and are expected generally to offset any cash payments the Company is required to make upon exchange of the Notes in excess of the principal amount thereof in the event that the market value per ordinary share, as measured under the Finance Contract arecapped call transactions, is greater than the strike price of the capped call transactions, with such offset being subject to certain covenantsan initial cap price of $100.00 per share. The capped call transactions expire on December 15, 2025 and must be settled in cash. If the capped call transactions are converted or redeemed early, settlement occurs at their termination value, which is equal to their fair value at the time of the redemption. The capped call transactions are carried on the condensed consolidated balance sheets as a derivative asset at their estimated fair value and are adjusted at the end of each reporting period, with unrealized gain or loss reflected within foreign exchange and other terms and conditions. No loan drawdowns have occurredgains/(losses) in the condensed consolidated statements of income (loss). The fair value of the capped call derivative assets was $96.7 million as of September 30, 2017.March 31, 2022. As of March 31, 2022, the capped call derivative assets are classified as long-term.
Note 8.6. 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”)FX derivative contracts and interest rate swap contracts to reduce the impact of foreign currency rate and interestexchange rate fluctuations on earnings and cash flow. We are also exposed to equity price risk in connection with our Notes, including exchange and settlement provisions based on the price of our ordinary shares at exchange or maturity of the Notes. In addition, the capped call transactions associated with the Notes also include settlement provisions that are based on the price of our ordinary shares, subject to a capped price per share. We do not enter into derivative contracts for speculative purposes.
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 the consolidated statement of income (loss).below. 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 in earnings.inception. 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, 2022 and December 31, 20162021 was $239.0$93.8 million and $489.1$136.7 million, respectively. These derivative contracts are designed to offset the FX effects in earnings of various intercompany loans our EIB loan, and trade receivables. We recorded net lossesgains for these freestanding derivatives of $0.7$1.0 million and $7.9$7.7 million for the three and nine months ended September 30, 2017, respectively,March 31, 2022 and net gains (losses) of $(1.8) million and $0.4 million for the three and nine months ended September 30, 2016,2021, respectively. These gains and losses are included in ‘Foreignforeign exchange and other gains gains/(losses)’ in the on our condensed consolidated statements of income (loss).
Counterparty Credit Risk
We are exposed to credit risk in the event of non-performance by the counterparties to our derivatives.
The two counterparties to the capped call transactions are financial institutions. To limit our credit risk, we selected financial institutions with a minimum long-term investment grade credit rating. Our exposure to the credit risk of the counterparties is not secured by any collateral. If a counterparty becomes subject to insolvency proceedings, we will become an unsecured creditor in those proceedings, with a claim equal to our exposure at that time under the capped call transactions with that counterparty.
To manage credit risk with respect to our other derivatives, the Company selects and periodically reviews counterparties based on credit ratings, limits its exposure with respect to each counterparty, and monitors the market positions. However, if one or more of these counterparties were in a liability position to the Company and were unable to meet their obligations, any transactions with the counterparty could be subject to early termination, which could result in substantial losses for the Company.
18


Cash Flow Hedges
NotionalWe utilize FX derivative contracts, designed as cash flow hedges, to hedge the variability of cash flows associated with our 12-month U.S. dollar forecasts of revenues and costs denominated in British Pound, Japanese Yen and the Euro. We transfer to earnings from AOCI the gain or loss realized on the FX derivative contracts at the time of invoicing.
The gross notional amounts of open derivative contracts designated as cash flow hedges at March 31, 2022 and December 31, 2021 were as follows (in thousands):
Description of Contract September 30, 2017 December 31, 2016
FX derivative contracts to be exchanged for British Pounds $16,928
 $6,663
FX derivative contracts to be exchanged for Japanese Yen 44,618
 57,840
FX derivative contracts to be exchanged for Canadian Dollars 13,341
 
Interest rate swap contracts 62,917
 63,246
  $137,804
 $127,749
Description of Derivative ContractMarch 31, 2022December 31, 2021
FX derivative contracts to be exchanged for British Pounds$8,126 $11,160 
FX derivative contracts to be exchanged for Japanese Yen3,334 6,648 
FX derivative contracts to be exchanged for Euros43,620 58,224 
$55,080 $76,032 
After-tax net lossgain 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 12 months are as follows (in thousands):
Description of Contract September 30, 2017 Net Amount Expected to be Reclassified to Earnings in the Next 12 Months
FX derivative contracts $(287) $(287)
Interest rate swap contracts (261) (69)
  $(548) $(356)
Description of Derivative ContractAfter-Tax Net Loss in AOCI as of March 31, 2022After-Tax Net Loss in AOCI as of March 31, 2022 Expected to be Reclassified to Earnings in Next 12 Months
FX derivative contracts$(1,640)$(1,640)
Pre-tax gains (losses) for derivative contracts designated as cash flow hedges recognized in Other Comprehensive Income (Loss)other comprehensive income (loss) (“OCI”) and the amount reclassified to earnings from AOCI were as follows (in thousands):
Three Months Ended March 31,
20222021
Description of Derivative ContractLocation in Earnings of Reclassified Gain or LossLosses Recognized in OCIGains (Losses) Reclassified from AOCI to EarningsLosses Recognized in OCI(Losses) Gains Reclassified from AOCI to Earnings
FX derivative contractsForeign exchange and other gains/(losses)$(642)$441 $(2,223)$(1,496)
FX derivative contractsSG&A— (388)— 685 
$(642)$53 $(2,223)$(811)
    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


We offset fair value amounts associated with our derivative instruments on our condensed consolidated balance sheets that are executed with the same counterparty under master netting arrangements. Our netting arrangements include a right to set off or net together purchases and sales of similar products in the settlement process.
19

    Nine 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 Recognized in OCI Gains (Losses) Reclassified from AOCI to Earnings
FX derivative contracts Foreign exchange and other (losses) gains $(10,124) $(6,833) $(5,932) $2,943
FX derivative contracts SG&A 
 1,623
 
 (3,437)
Interest rate swap contracts Interest expense 
 1,009
 (38) (252)
    $(10,124) $(4,201) $(5,970) $(746)

The following tables present the fair value on a gross basis, and the location of derivative contracts reported inon the condensed consolidated balance sheets (in thousands):
March 31, 2022Asset DerivativesLiability Derivatives
Derivatives Designated as Hedging InstrumentsBalance Sheet Location
Fair Value (1)
Balance Sheet Location
Fair Value (1)
FX derivative contractsCurrent derivative assets$262 Current derivative liabilities$1,946 
Total derivatives designated as hedging instruments262 1,946 
Derivatives Not Designated as Hedging Instruments
FX derivative contractsCurrent derivative assetsCurrent derivative assets183 
FX derivative contractsCurrent derivative liabilities18 
Capped call derivativesLong-term derivative assets96,717 
Embedded exchange featureLong-term derivative liabilities170,660 
Total derivatives not designated as hedging instruments96,738 170,843 
Total derivatives$97,000 $172,789 
December 31, 2021Asset DerivativesLiability Derivatives
Derivatives Designated as Hedging InstrumentsBalance Sheet Location
Fair Value (1)
Balance Sheet Location
Fair Value (1)
FX derivative contractsAccrued liabilities$243 Accrued liabilities$1,286 
Total derivatives designated as hedging instruments243 1,286 
Derivatives Not Designated as Hedging Instruments
FX derivative contractsAccrued liabilities61 Accrued liabilities427 
Capped call derivativesCurrent derivative assets106,629 
Embedded exchange featureCurrent derivative liabilities181,700 
Total derivatives not designated as hedging instruments106,690 182,127 
Total derivatives$106,933 $183,413 
(1)For the classification of inputs used to evaluate the fair value of our derivatives, refer to “Note 4. Fair Value Measurements.”
September 30, 2017 Liability Derivatives
Derivatives Designated as Hedging Instruments Balance Sheet Location 
Fair Value (1)
Interest rate swap contracts Accrued liabilities $875
Interest rate swap contracts Other long-term liabilities 932
FX derivative contracts Accrued liabilities 724
Total derivatives designated as hedging instruments 
 2,531
Derivatives Not Designated as Hedging Instruments 
 
FX derivative contracts Accrued liabilities 1,456
Total derivatives not designated as hedging instruments 
 1,456
  
 $3,987
December 31, 2016 Asset Derivatives Liability Derivatives
Derivatives Designated as Hedging Instruments 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
Interest rate swap contracts Other assets 
 Other long-term liabilities 1,392
FX derivative contracts Prepaid expenses and other current assets 4,911
 Accrued liabilities 
Total derivatives designated as hedging instruments   4,911
   2,334
Derivatives Not Designated as Hedging Instruments        
FX derivative contracts Prepaid expenses and other current assets 3,358
 Accrued liabilities 
Total derivatives not designated as hedging instruments   3,358
   
    $8,269
   $2,334
(1)For the classification of input used to evaluate the fair value of our derivatives, refer to “Note 6. Fair Value Measurements.”


Note 9.7. 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 two2 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 arewere 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 had
20


informed us that the import alert iswas limited to the 3T devices, but that the agency reservesreserved the right to expand the scope of the import alert if future circumstances warrantwarranted 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 remainwere 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 arewere reasonably related willwould not be approved until the violations havehad been corrected. However,corrected; however, this restriction appliesapplied only to the Munich and Arvada facilities, which do not manufacture or design devices subject to Class III premarket approval.
We continueOn February 25, 2020, LivaNova received clearance for K191402, a 510(k) for the 3T devices that addressed issues contained in the 2015 Warning Letter along with design changes that further mitigate the potential risk of aerosolization. Concurrent with this clearance, (1) 3T devices manufactured in accordance with K191402 will not be subjected to work diligentlythe import alert and (2) LivaNova initiated a correction to distribute the updated Operating Instructions cleared under K191402. With this 510(k) clearance, all actions to remediate the FDA’s inspectional observations for the Munich facility, as well as the additional issues identified in the Warning Letter.Letter were complete, and LivaNova awaited the FDA’s close-out inspection.
On April 28, 2022, the FDA completed its close-out inspection of the Munich, Germany facility and, at the conclusion of the inspection, issued a Form 483 which contained three inspectional observations in the areas of design validation, process validation and complaint investigations. We take these matters seriouslyare preparing a detailed response to the FDA commenting on the Form 483 observations in the context of our previous actions and remediation efforts to the 2015 Warning Letter, including the January 2016 informational Customer Letter; shipment of products pursuant to our certificate of medical necessity program; and the activities that we conducted to obtain clearance of K191402 for the modified 3T device. We intend to respond timely and fullysubmit our response to the FDA’s requests.FDA within 15 working days of receiving the Form 483 and will also include our proposed corrective and preventive actions to address the FDA's observations. While we intend to resolve the issues raised by the FDA in our response, whether the FDA will accept our response is uncertain. Refer to “Part II, Item 1A. Risk Factors” in this Form 10-Q for additional information regarding the risks surrounding receipt of the Form 483.
CDC and FDA Safety Communications and Company Field Safety Notice Update
On October 13, 2016, the CentersCenter for Disease Control and Prevention (“CDC”(the “CDC”) and the 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 the 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. This loanerworldwide, including a vacuum canister and internal sealing upgrade program beganand a deep disinfection service. In April 2017, we obtained CE Mark in Europe for the design change of the 3T device, and in October 2018, the FDA concluded that we could commence the vacuum canister and internal sealing upgrade program in the U.S. On February 25, 2020, LivaNova received clearance for K191402, a 510(k) for the 3T devices that addressed issues contained in the 2015 Warning Letter along with design changes that further mitigate the potential risk of aerosolization. We are in the process of completing and is being made available progressively on a global basis, prioritizingclosing out all recall activities with the FDA. While our vacuum canister and allocating devices to 3T device users based on pre-established criteria. We anticipate that thisinternal sealing upgrade program and deep cleaning service in the U.S. are substantially complete, these services will continue until we are able to address customer needs throughas a broader solution that includes implementation of one or moreservicing option outside of the risk mitigation strategies currently under review with regulatory agencies.U.S.
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 Decemberduring the fourth quarter of 2016, and furthermore, the cost associated with the plan was reasonably estimable. At September 30, 2017,March 31, 2022, the product remediation liability was $30.2$0.8 million. ReferSince clearance
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for K191402 was received, the liability associated with 3T remediation efforts has declined over time such that the Company has concluded that, at this point in time, the current/future liability is immaterial, and we do not intend to “Note 4. Product Remediation Liability”provide further disclosure on this matter.
Saluggia Site Hazardous Substances
LivaNova Site Management S.r.l. (“LSM”), formerly a subsidiary of Sorin, one of the companies that merged into LivaNova PLC in 2015, manages site services for additional information.the campus in Saluggia, Italy. In addition to a LivaNova manufacturing facility, the Saluggia campus is also the location of manufacturing facilities of third parties, a cafeteria for workers, and storage facilities for hazardous substances and equipment previously used in a nuclear research center, later turned nuclear medicine business, between the 1960s and the late 1990s. Pursuant to authorization from the Italian government, LSM has, and continues to, perform ordinary maintenance, secure the facilities, monitor air and water quality and file applicable reports with the competent environmental authorities.

During 2020, LSM received correspondence from ISIN (a sub-body of the Italian Ministry of Economic Development) requesting that within five years, LSM demonstrate the financial capacity to meet its obligations under Italian law to clean and dismantle any contaminated buildings and equipment as well as to deliver hazardous substances to a national repository. This repository will be built by the Italian government at a location and time yet to be determined. ISIN subsequently published Technical Guide n. 30, which identifies the technical criteria, and general safety and protection requirements for the design, construction, operation and dismantling of temporary storage facilities for the hazardous substances. In January 2021, a list of 67 potential sites for the national repository was published.

Although there is no legal obligation to begin any work or deliver the hazardous substances, as the performance of these obligations is contingent on the construction of the as-yet unbuilt national repository, based on the aforementioned factors, the Company concluded its obligation to clean, dismantle, and deliver any hazardous substances to a national repository is probable and reasonably estimable. The estimated liability as of March 31, 2022 was $38.3 million, which represented the low end of the estimated range of loss of $38.3 million to $48.7 million. The estimated liability as of December 31, 2021 was $39.3 million. The decrease in the liability from December 31, 2021 was primarily due to the effects of foreign currency changes during the three months ended March 31, 2022.
Litigation
On February 12, 2016, LivaNova was alerted that a class action complaint had been filedProduct Liability
The Company is currently involved in litigation involving our 3T device. The litigation includes federal multi-district litigation in the U.S. District Court for the Middle District of Pennsylvania, with respect to our 3T devices. The plaintiffs namedvarious U.S. state court cases and cases in jurisdictions outside the U.S. A class action, filed in February 2016 in the complaint underwent open heart surgeries at WellSpan York Hospital and Penn State Milton S. Hershey Medical Center in 2015, andU.S. District Court for the complaint alleges that: (i) patients were exposed to a harmful formMiddle District 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 consistsPennsylvania, consisting 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.infection, was dismissed on July 16, 2021. 
On October 23, 2017,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. District Court forfederal court, the Middle District of Pennsylvania issued an order certifying a class with respect to the named plaintiffs. Therelated 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.,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, againstprovides for a total payment of up to $225 million to resolve the claims covered by the settlement. Per the agreed-upon terms, the first payment of $135 million was paid into a qualified settlement fund in July 2019 and the second payment of $90 million was paid in January 2020. Cases covered by the settlement are being dismissed as amounts are disbursed to individual plaintiffs from the qualified settlement fund.
Cases in state courts in the U.S. and in jurisdictions outside the U.S. continue to progress. As of May 4, 2022, including the cases encompassed in the settlement framework described above that have not yet been dismissed, we were aware of approximately 90 filed and unfiled claims worldwide, with the majority of the claims in various LivaNova entities.federal or state courts throughout the United States. This number includes 5 cases that have settled but have not yet been dismissed. The complaints generally seek damages and 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.
WeAt March 31, 2022, the provision for these matters was $36.2 million. While the amount accrued represents our best estimate for those filed and unfiled claims that we believe are defending eachboth probable and estimable at this time, and which are a subset of thesethe filed and unfiled claims vigorously. Givenworldwide of which we are currently aware, the relatively early stageactual liability for resolution of these matters we cannot give any assurances that additional legal proceedings makingmay vary
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from our estimate. The remaining claims for which a provision has not been recorded are remote or 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 rangeestimable at this time.
Changes in the carrying amount of potential loss, if any, that may result from these matters.the litigation provision liability are as follows (in thousands):
Other Litigation
Total litigation provision liability at December 31, 2021$39,470 
Payments(2,754)
Adjustments (1)
(343)
FX and other(142)
Total litigation provision liability at March 31, 202236,231 
Less current portion of litigation provision liability at March 31, 202230,126 
Long-term portion of litigation provision liability at March 31, 2022 (2)
$6,105 
SNIA Litigation(1)Adjustments to the litigation provision are included within other operating expenses on the condensed consolidated statements of income (loss).
(2)Included within other long-term liabilities on the condensed consolidated balance sheet.
Environmental Liability
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, became effective onin January 2, 2004. Pursuant to the Italian Civil Code,2004, and in a spin-off transaction, the parent 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 byOctober 2015, Sorin was approximately €573 million (approximately $676 million).
We believemerged into LivaNova. SNIA subsequently became insolvent, 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 arewere 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 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 namedcompany; the Public Administrations entered voluntarily into the Italian Ministry of the Environment and other Italian government agencies,proceeding, asking Sorin, as defendants, in orderjointly liable with SNIA, to have them bound to the final ruling.
pay compensation for SNIA’s environmental damages. 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),€292,000 (approximately $323,901 as of March 31, 2022) 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 hearingMilan (“Court of Appeal”). On March 5, 2019, the Court of Appeal issued a partial decision on the merits declaring Sorin/LivaNova jointly liable with SNIA for SNIA’s environmental liabilities in an amount up to the fair value of the appeal proceedings was heldnet worth received by Sorin because of the Sorin spin-off, an estimated €572.1 million (approximately $634.6 million as of March 31, 2022). We appealed the partial decision on liability to the Italian Supreme Court in August 2019.
In November 2021, the Court of Appeal delivered the remainder of its decision, ordering LivaNova to pay damages of approximately €453.6 million (approximately $503.1 million as of March 31, 2022). We appealed the decision on damages in December 2016,2021, and in early 2022, the final hearing is now scheduled for November 22, 2017. AfterItalian Supreme Court agreed to combine the hearing, the parties will file their final briefs,appeals on liability and damages. On February 21, 2022, the Court is expected to render its decision in mid-2018. SNIA did not file an appeal.


We (as successor to Sorin inof Appeal notified the litigation) continue to believeCompany that it granted the risk of material loss relatingCompany a suspension with respect to the SNIA litigation is not probablepayment of damages until a decision has been reached on the appeal to the Italian Supreme Court. This suspension was subject to our providing a first demand bank guarantee of €270.0 million (approximately $299.5 million as a resultof March 31, 2022) within 30 calendar days. On March 21, 2022, LivaNova delivered the guarantee as required by the Court of Appeal, thereby satisfying the condition to obtain the suspension of the reasoning contained in, and legal conclusions reached in,Court of Appeal’s judgment for the recent court decisions described above. We also believe that the amountpayment 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.
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 continueuntil review of such judgment by the Italian Supreme Court. Refer to contest them vigorously, there can be no assurance as“Note 5. Financing Arrangements” for information on the financing of the guarantee.
In 2011, Caffaro, a SNIA subsidiary, sold its Brescia chemical business to Caffaro Brescia, a third party belonging to the outcome. A finding during any appeal or novel proceedings that we are liable for environmental damageTodisco group, and as part of the acquisition, Caffaro Brescia agreed to secure hydraulic barriers at the site and maintain existing environmental security measures. In September 2020, Caffaro Chemical Sites orBrescia declared it was withdrawing from 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, Sorinagreement to maintain the environmental measures. In January 2021, we (in addition to Caffaro Brescia, and other direct and indirect shareholders of SNIAnon-LivaNova entities) received an administrative order (the “Remediation (“Order”) from the Italian Ministry of the Environment (the “Ministry”), directing themrequiring us to promptly commenceensure the maintenance of the environmental remediation effortsmeasures and to guarantee that such works remain fully operational, the annual management and maintenance for which is estimated at approximately €1 million per year. LivaNova’s receipt of the Caffaro Chemical Sites (as described above). We (as successorOrder appears to Sorin) believe that we should not be liablebased
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on the aforementioned Court of Appeal decision regarding our alleged joint liability with SNIA for damages relating toSNIA’s environmental liabilities. Our response, dated February 16, 2021, disputes the Caffaro Chemical Operations pursuant to the Italian statute ongrounds upon which the Remediation Order relies because, inter alia,is based. We also appealed the statute does not apply to activities occurring prior to 2006, the date on which the statute was enacted. (Sorin was spun off from SNIAOrder 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”).Brescia.
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 expensea liability in connection with these related matters because any potential loss is not currently probable.
Contract Litigation
On November 25, 2019, LivaNova received notice of a lawsuit initiated by former members of Caisson Interventional, LLC (“Caisson”), a subsidiary of the Company acquired in 2017. The lawsuit, Todd J. Mortier, as Member Representative of the former Members of Caisson Interventional, LLC v. LivaNova USA, Inc., is currently pending in the United States District Court for the District of Minnesota. The complaint alleges (i) breach of contract, (ii) breach of the covenant of good faith and fair dealing and (iii) unjust enrichment in connection with the Company’s operation of Caisson’s Transcatheter Mitral Valve Replacement (“TMVR”) program and the Company’s November 20, 2019 announcement that it was ending the TMVR program at the end of 2019. The lawsuit seeks damages arising out of the 2017 acquisition agreement, including various regulatory milestone payments. We intend to vigorously defend this claim. The Company has not recognized a liability related to 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, asking the Court to prohibit the execution of the Merger. In its initial decision on August 20, 2015, the Court authorized the Merger and the Public Administrations did not appeal this decision. The proceeding then continued as a civil case, with the Public Administration seeking damages against us. The Commercial Court of Milan delivered a decision in October 2016, fully rejecting the Public Administration’s request and awarding us €200,000 (approximately $228,000) in damages for frivolous litigation, plus €200,000 (approximately $228,000) in 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. The Court of Appeal is likely to make a decision in mid-June 2018. 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 in October 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), 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) in February 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, where the matters are still pending.
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). 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 million (approximately $20.0 million).
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. Stockholders’8. Stockholders' Equity
Comprehensive incomeThe tables below present the condensed consolidated statements of stockholders’ equity as of and for the three months ended March 31, 2022 and 2021 (in thousands):
Ordinary SharesOrdinary Shares - AmountAdditional Paid-In CapitalTreasury StockAccumulated Other Comprehensive Income (Loss)
Accumulated Deficit (1)
Total Stockholders' Equity (1)
December 31, 202153,762 $82,295 $2,117,961 $(650)$(7,177)$(897,784)$1,294,645 
Stock-based compensation plans3,137 31 — — 3,171 
Net income— — — — — 2,993 2,993 
Other comprehensive loss— — — — (8,955)— (8,955)
March 31, 202253,764 $82,298 $2,121,098 $(619)$(16,132)$(894,791)$1,291,854 
December 31, 202049,447 $76,300 $1,768,156 $(1,034)$27,809 $(761,966)$1,109,265 
Stock-based compensation plans10 2,251 236 — — 2,497 
Net loss— — — — — (30,761)(30,761)
Other comprehensive income— — — — (25,871)— (25,871)
March 31, 202149,455 $76,310 $1,770,407 $(798)$1,938 $(792,727)$1,055,130 
(1)Accumulated deficit and total stockholders’ equity as of March 31, 2021 and net loss for the three months ended March 31, 2021 have been revised. For further details refer to “Note 1. Unaudited Condensed Consolidated Financial Statements.”
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The table below presents the change in each component of AOCI, net of tax, and the reclassifications out of AOCI into net earningsincome for the ninethree months ended September 30, 2017March 31, 2022 and September 30, 20162021 (in thousands):
Change in Unrealized Gain (Loss) on Derivatives
Foreign Currency Translation Adjustments Gain (Loss) (1)
Total
December 31, 2021$(945)$(6,232)$(7,177)
Other comprehensive loss before reclassifications, before tax(642)(8,260)(8,902)
Tax benefit— — — 
Other comprehensive loss before reclassifications, net of tax(642)(8,260)(8,902)
Reclassification of loss from accumulated other comprehensive income, before tax(53)— (53)
Reclassification of tax benefit— — — 
Reclassification of loss from accumulated other comprehensive income, after tax(53)— (53)
Net current-period other comprehensive loss, net of tax(695)(8,260)(8,955)
March 31, 2022$(1,640)$(14,492)$(16,132)
December 31, 2020$2,319 $25,490 $27,809 
Other comprehensive income before reclassifications, before tax(1,146)(25,875)(27,021)
Tax expense534 — 534 
Other comprehensive income before reclassifications, net of tax(612)(25,875)(26,487)
Reclassification of loss from accumulated other comprehensive income (loss), before tax811 — 811 
Reclassification of tax benefit(195)— (195)
Reclassification of loss from accumulated other comprehensive income (loss), after tax616 — 616 
Net current-period other comprehensive income, net of tax(25,875)(25,871)
March 31, 2021$2,323 $(385)$1,938 
(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.
  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)
(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 11.9. Stock-Based Incentive Plans
Stock-based incentive plans compensation expense is as follows (in thousands):
Three Months Ended March 31,
 Three Months Ended September 30, Nine Months Ended September 30,20222021
 2017 2016 2017 2016
Service-based stock appreciation rights ("SARs") $2,535
 $1,983
 $6,001
 $6,567
Service-based restricted stock units ("RSUs") 2,225
 2,517
 6,718
 8,419
Service-based restricted stock units (“RSUs”)Service-based restricted stock units (“RSUs”)$5,344 $4,842 
Service-based stock appreciation rights (“SARs”)Service-based stock appreciation rights (“SARs”)2,938 3,322 
Market performance-based restricted stock units 301
 14
 482
 17
Market performance-based restricted stock units851 763 
Operating performance-based restricted stock units 636
 254
 1,060
 572
Operating performance-based restricted stock units785 267 
Employee share purchase planEmployee share purchase plan338 342 
Total stock-based compensation expense $5,697
 $4,768
 $14,261
 $15,575
Total stock-based compensation expense$10,256 $9,536 
During the ninethree months ended September 30, 2017,March 31, 2022, 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 and are subject to forfeiture unless service conditions are met. MarketThe market performance-based awards that were issued cliff vest ratably over fourafter three years subject to forfeiture unless certain future pricesthe rank of our sharestotal shareholder return for the three-year period ending December 31, 2024 relative to the total shareholder returns for a peer group of companies. The adjusted free cash flow and return on the NASDAQ Stock Market exceed certain threshold prices in the first year following the grant date. And finally,invested capital operating performance-based awards that were issued cliff vest ratably over fourafter three years subject to forfeiture unlessthe achievement of certain thresholds of adjusted net sales and adjusted net income are metcumulative results for fiscal year 2017.the three-year period ending December 31, 2024. Compensation expense related to award agreements executedawards granted during 20172022 for the three and nine months ended September 30, 2017 were $2.0 million and $3.2 million, respectively.March 31, 2022 was $0.1 million.
25


Stock-based compensation agreements executedissued during the ninethree months ended September 30, 2017,March 31, 2022, representing potential shares and their weighted average grant date fair values by type follows (shares in thousands, fair value in dollars):
Three Months Ended March 31, 2022
SharesWeighted Average Grant Date Fair Value
Service-based SARs553,050 $34.13 
Service-based RSUs246,824 $82.04 
Market performance-based RSUs44,180 $103.02 
Operating performance-based RSUs44,174 $82.04 
  Nine Months Ended September 30, 2017
  Shares Weighted Average Grant Date Fair Value
Service-based SARs 639
 $17.03
Service-based RSUs 108
 $57.37
Market performance-based RSUs 158
 $25.29
Operating performance-based RSUs 189
 $56.18
Note 12.10. 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 consolidated effective income tax rates of 6.1% and 9.3%, respectively.
Our consolidated effective income tax rate for the three and nine months ended September 30, 2017 includedMarch 31, 2022 was 45.6% compared with (9.4)% for the impact of various discretethree months ended March 31, 2021. Our effective income tax items, including a net $4.0 million deferredrate fluctuates based on, among other factors, changes in pretax income in countries with varying statutory tax benefit due to the release ofrates, valuation allowances, on tax losses uponcredits and incentives, and unrecognized tax benefits associated with uncertain tax positions.
We continually assess the completion of a reorganizationrealizability 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 millionworldwide deferred tax asset related to a reserve for an uncertain tax position recognized in a prior year, in addition to various other discrete items.and valuation allowance positions, and when the need arises, we establish or release valuation allowances accordingly.
DuringCompared with 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. TheMarch 31, 2021, the change in the effective tax rate for the ninethree months ended September 30, 2016March 31, 2022 was impacted byprimarily attributable to changes in the recording of valuation allowances and changes in income before tax in countries with varying statutory tax rates as compared to changes in valuation allowances and other discrete items during the three months ended March 31, 2021.
We operate in multiple jurisdictions throughout the world, and our tax returns are periodically audited or subjected to review by tax authorities. As a result, there is an uncertainty in income taxes recognized in our financial statements. Tax benefits totaling $1.7 million and $1.7 million were unrecognized as of $23.9 million relatedMarch 31, 2022 and December 31, 2021, respectively. It is reasonably possible that, within the next twelve months, due to certainthe settlement of uncertain tax jurisdictions, including Francepositions with various tax authorities and the UK, in which we did not recordexpiration of statutes of limitations, unrecognized tax benefits generatedcould decrease 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.

up to approximately $0.6 million.

Note 13. Net Income (Loss)11. Earnings Per Share
The following table sets forthReconciliation of the shares used in the basic and diluted earnings per share computations for the three months ended March 31, 2022 and 2021 are as follows (in thousands):
Three Months Ended March 31,
20222021
Basic weighted average shares outstanding53,300 48,736 
Add effects of share-based compensation instruments (1)
876 — 
Diluted weighted average shares outstanding54,176 48,736 
(1)Excluded from the computation of basic and diluted net income (loss)earnings per share (in thousands, except perwere stock options, SARs and restricted share data):units totaling 2.2 million and 4.3 million for the three months ended March 31, 2022 and 2021, respectively, because to include them would have been anti-dilutive under the treasury stock method.
  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)
(1)
Excluded from the computation of diluted earnings per share for the three and nine months ended September 30, 2017 were 1.6 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, because to include them would have been anti-dilutive due to the net losses.
Note 14.12. 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, developing and executing our strategy, and assessing performance. We have three3 reportable segments: Cardiac Surgery,Cardiopulmonary, Neuromodulation and Cardiac Rhythm Management.Advanced Circulatory Support.
The Cardiac SurgeryOur Cardiopulmonary segment generates its revenue fromis engaged in the development, production and sale of cardiovascular surgery products. Cardiac Surgerycardiopulmonary products, includeincluding oxygenators, heart-lung machines, autotransfusion systems, mechanical heart valvesperfusion tubing systems, cannulae and tissue heart valves.other related accessories.
TheOur Neuromodulation segment generates its revenue fromis engaged in the design, development and marketing of devices that deliver neuromodulation therapy for the treatment ofto treat drug-resistant epilepsy (“DRE”), difficult-to-treat depression (“DTD”) and treatment resistant depression.obstructive sleep apnea (“OSA”). 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 parameters for the patient, instruction manuals and magnets to suspend or induce stimulation manually.other accessories.
The Cardiac Rhythm Management
26


Our Advanced Circulatory Support segment generates its revenue fromis engaged in the development, manufacturingproduction and marketingsale of products for the diagnosis, treatment, and management of heart rhythm disorders and heart failure. Cardiac Rhythm Managementleading-edge temporary life support products. These products include high-voltage defibrillators, cardiac resynchronization therapy devicescardiopulmonary and low-voltage pacemakers.respiratory support solutions consisting of temporary life support controllers and product kits that can include a combination of pumps, oxygenators, and cannulae.
“Other” includes Corporatecorporate shared servicesservice expenses for finance, legal, human resources, and information technology and Corporatecorporate business development (“New Ventures”). New Ventures,development. For 2021, other also includes the results of our Heart Valves business, which includes our recent Caisson acquisition, is focusedwas disposed of on new growth platforms and identification of other opportunities for expansion.June 1, 2021.
Net sales of our reportable segments include end-customer revenues from the sale of products theythat each developreportable segment develops and manufacturemanufactures or distribute.distributes. We define segment income as operating income before merger and integration, restructuring and amortization of intangibles.


NetWe operate under 3 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 March 31,
20222021
Cardiopulmonary
United States$38,096 $35,759 
Europe32,067 30,626 
Rest of World46,912 42,334 
117,075 108,719 
Neuromodulation
United States87,210 82,300 
Europe12,456 11,679 
Rest of World10,561 9,720 
110,227 103,699 
Advanced Circulatory Support
United States10,963 12,560 
Europe603 228 
Rest of World117 204 
11,683 12,992 
Other (1)
United States— 2,717 
Europe— 8,284 
Rest of World1,190 11,192 
1,190 22,193 
Totals
United States136,269 133,336 
Europe (2)
45,126 50,817 
Rest of World58,780 63,450 
Total (3)
$240,175 $247,603 
  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
(1)For 2021, other primarily includes the net sales of the Company’s Heart Valves business, which was disposed of on June 1, 2021.
(2)Europe includes 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.
(3)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.
27

  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 ourtable below presents a reconciliation of segment income to consolidated income (loss) before tax (in thousands):
Three Months Ended March 31,
2022
2021 (1)
Cardiopulmonary$6,895 $1,442 
Neuromodulation37,478 34,083 
Advanced Circulatory Support(5,438)2,393 
Other (2)
(23,082)(30,195)
Total reportable segment income15,853 7,723 
Other expenses (3)
6,348 13,421 
Operating income (loss)9,505 (5,698)
Interest expense(7,840)(15,936)
Foreign exchange and other gains/(losses)3,904 (6,443)
Income (loss) before tax$5,569 $(28,077)
(1)Segment income for the three months ended March 31, 2021 has been revised. For further details refer to “Note 1. Unaudited Condensed Consolidated Financial Statements.”
(2)Other includes corporate shared service expenses for finance, legal, human resources, information technology and corporate business development. For 2021, other also includes the results of the Company’s Heart Valves business, which was disposed of on June 1, 2021.
(3)Other expenses primarily consist of amortization of intangible assets for the three months ended March 31, 2022, as well as merger and capitalintegration expense and restructuring expense during the three months ended March 31, 2021.
Assets by segment are as follows (in thousands):
March 31, 2022December 31, 2021
Cardiopulmonary$905,140 $921,481 
Neuromodulation653,484 646,394 
Advanced Circulatory Support230,278 231,846 
Other627,981 401,230 
Total$2,416,883 $2,200,951 
Capital expenditures by segment are as follows (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 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


Three Months Ended March 31,
20222021
Cardiopulmonary$1,829 $3,049 
Neuromodulation84 40 
Advanced Circulatory Support684 556 
Other2,983 1,469 
Total$5,580 $5,114 
The changes in the carrying amount of goodwill by reportable segment for the ninethree months ended September 30, 2017March 31, 2022 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
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):
CardiopulmonaryNeuromodulationAdvanced Circulatory SupportTotal
December 31, 2021$398,245 $398,754 $102,526 $899,525 
Foreign currency adjustments(2,926)— — (2,926)
March 31, 2022$395,319 $398,754 $102,526 $896,599 
28

  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):
March 31, 2022December 31, 2021
United States$62,099 $60,852 
Europe80,987 85,313 
Rest of World4,871 3,901 
Total$147,957 $150,066 
PP&E September 30, 2017 December 31, 2016
United States $62,630
 $61,279
Europe 137,682
 130,777
Rest of world 13,457
 31,786
Total $213,769
 $223,842
Note 15.13. 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):
March 31, 2022December 31, 2021
Raw materials$48,367 $43,958 
Work-in-process16,846 14,161 
Finished goods49,631 47,721 
 $114,844 $105,840 

 September 30, 2017 December 31, 2016
Raw materials $51,628
 $47,704
Work-in-process 39,873
 32,316
Finished goods 123,092
 103,469
  $214,593
 $183,489
Inventories are reported netAs of the provision for obsolescence which totaled $13.7 million and $9.8 million at September 30, 2017March 31, 2022 and December 31, 2016, respectively.
Prepaid expenses2021, inventories include adjustments totaling $9.8 million and other current assets consisted$8.9 million, respectively, to record balances at lower 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.


cost or net realizable value.
Accrued liabilities and other consisted of the following (in thousands):
March 31, 2022December 31, 2021
Contingent consideration (1)
$11,268 $11,552 
Operating lease liabilities10,967 11,261 
Legal and other administrative costs10,751 8,948 
Amount payable to Gyrus Capital S.A.9,610 11,418 
Contract liabilities8,722 8,419 
Research and development costs5,638 5,329 
Interest payable2,516 359 
Provisions for agents, returns and other2,029 2,535 
Other accrued expenses30,525 29,116 
$92,026 $88,937 
  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
(1)Refer to “Note 4. Product Remediation Liability.”
(2)Refer to “Note 8. Derivatives and Risk Management.”
(1)Refer to “Note 4. Fair Value Measurements”
OtherAs of March 31, 2022 and December 31, 2021, contract liabilities of $10.5 million and $9.8 million, respectively, are included within accrued liabilities and other long-term liabilities consistedon the condensed consolidated balance sheets.
29


The table below presents the items included within foreign exchange and other gains/(losses) on the condensed consolidated statements of the followingincome (loss) (in thousands):
Three Months Ended March 31,
20222021
Exchangeable Notes fair value adjustment (1)
$11,040 $(26,335)
Capped call fair value adjustment (1)
(9,912)12,550 
Investment revaluation (2)
— 4,642 
Other derivative liabilities fair value adjustment— 3,167 
Foreign exchange rate fluctuations2,791 (409)
Interest income20 (74)
Other(35)16 
Foreign exchange and other gains/(losses)$3,904 $(6,443)

 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.”
(4)Unfavorable operating leases represent the adjustment to recognize future lease obligations at their estimated fair value in conjunction with the Mergers.
(1)Refer to “Note 4. Fair Value Measurements”
Note 16. New Accounting Pronouncements(2)Refer to “Note 3. Investments”
In May 2014, the Financial Accounting Standards Board (“FASB”) issued ASC Update (“ASU”) No. 2014-09, Revenue from Contracts with Customers. Update No. 2014-09 requires an entity to recognize the amountThe table below presents a reconciliation of revenue to which it expects to be entitled for the transfer of promised goods or services to customerscash, cash equivalents 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.


Basedrestricted cash reported on the Company’s evaluation performedcondensed consolidated balance sheets that sum to date, we believe the timing of revenue recognition for products and related revenue streams within our Neuromodulation and Cardiac Rhythm Management segments will not materially change. The Company continues to evaluate the impacttotal of the new standardamounts shown 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 conditions that may require consideration under the standard are properly identified and analyzed. During the fourth quarter of 2017, we expect to finalize our 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 ourcondensed consolidated financial statements and related disclosures.
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,(in thousands):
March 31, 2022December 31, 2021
Cash and cash equivalents$128,737 $207,992 
Restricted cash (1)
313,647 — 
Cash, cash equivalents and restricted cash$442,384 $207,992 
(1)Restricted cash represents funds held as collateral for the SNIA Litigation Guarantee. Refer to present gross windfall tax benefits“Note 7. Commitments and Contingencies.”
Note 14. Subsequent Event
Acquisition of ALung Technologies, Inc.
As of March 31, 2022, LivaNova owned a 3% investment in ALung Technologies, Inc. (“ALung”), a privately held medical device company focused on creating advanced medical devices for treating respiratory failure, with a carrying value of $3.0 million, as an inflow from financing activitieswell as a note receivable with a carrying value of $2.5 million. On May 2, 2022, we acquired the remaining 97% of equity interests in ALung for a purchase price of up to $110.0 million, consisting of $10.0 million paid at closing, subject to customary adjustments, and an outflow from operating activities.
Under the Amendment relatedcontingent considerations of up 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$100.0 million payable upon achievement of certain sales-based milestones beginning in 2023 and ending in 2027. Due 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 ofacquisition, 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,


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 theinitial 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 earningsthis acquisition is not complete as of the beginningfiling date 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.this Quarterly Report on Form 10-Q.
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.
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Item 2. Management’sDiscussion and Analysis of Financial Condition andResults 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 on2021 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 Part I, Item 1A1A. of our 20162021 Form 10-K, as updated and supplemented by our Quarterly Reports on Form 10-Q, including in Part II, Item 1A. and elsewhere in this quarterly report.Quarterly Report on Form 10-Q.
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.


Global Developments
COVID-19
The COVID-19 pandemic has caused and may continue to cause unpredictable demand for our products. Throughout the pandemic, healthcare customers have diverted medical resources and priorities towards the treatment of COVID-19, and public health bodies have delayed elective procedures, which has negatively impacted the usage of our products. Further, some people have avoided seeking treatment for non-COVID-19 procedures, and hospitals and clinics have experienced staffing shortages, which has negatively impacted the demand for our products. While the recent recovery of global cardiopulmonary procedures has resulted in stronger demand for our Cardiopulmonary products, our Neuromodulation and Advanced Circulatory Support businesses continue to experience ongoing COVID-19 related headwinds. We are monitoring the potential for various strains of the virus to cause a resumption of high levels of infection and hospitalization that, in turn, may affect the demand for our products.
Moreover, although our RECOVER study and ANTHEM-HFrEF pivotal trial continue to progress, there may be delays or closures of sites in the future should COVID-19 or variants thereof strengthen or reemerge.
Certain conditions improved during 2021, but we continue to experience COVID-19 related headwinds. Like many companies, for example, we are experiencing supply chain delays and interruptions, labor shortages, inflationary pressures and logistical issues in the wake of COVID-19. Though, to date, our supply of raw materials and the production and distribution of finished products have not been materially affected, demand and low capacity worldwide have caused longer lead times and put price pressure on key raw materials. Moreover, freight and labor costs at our manufacturing facilities have increased in the wake of inflation globally. The Company continues to respond to such challenges, and while we have business continuity plans in place, the impact of the ongoing challenges we are experiencing, along with their potential escalation, may adversely affect our business and the recoverability of our tangible and intangible assets. The future impact of pandemic-related developments remains uncertain.
Importantly, we continue to take actions in managing the health and safety of our employees throughout the pandemic. Though there has been no Company-wide mandate to return to the office, employees are encouraged to return for purposeful collaboration. We continue to maintain enhanced safety protocols and encourage our employees to seek vaccination. We have incurred additional expenses in connection with our response to the COVID-19 pandemic, including manufacturing inefficiencies and costs related to enabling our employees to support our customers while working remotely.
Ukraine Invasion
In February 2022, Russia launched an invasion in Ukraine which caused us to assess our ability to sell in the market due to international sanctions, to consider the potential impact of raw material sourced from the region, and to determine whether we are able to transact in a compliant fashion. Although the region represented 1% of our total net sales for 2021, the Russian invasion of Ukraine has increased economic uncertainties, and a significant escalation or continuation of the conflict could have a material, global impact on our operating results. In addition, our Russian employees and local subsidiary are subject to evolving laws and regulations imposed by the Russian authorities in response to international sanctions.
Business Overview
We are a public limited company organized under the laws of England and Wales and headquartered in London, United Kingdom.England. We are a global medical device company focused on the development and delivery of important therapeutic solutionsproducts and therapies for the benefit of patients, healthcare professionals and healthcare systems throughout the world. Working closely with medical professionals in the fields of Cardiac Surgery, Neuromodulation and Cardiac Rhythm Management, weWe design, develop, manufacture and sell innovative therapeutic solutionsproducts and therapies that are consistent with our mission to improve our patients’ qualityprovide hope to patients through innovative technologies, delivering life-changing improvements for both the Head and Heart.
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LivaNova is comprised of life, increase the skills and capabilities of healthcare professionals and minimize healthcare costs.
Business Franchises
We operate our business through three reportable segments: Cardiac Surgery,Cardiopulmonary, Neuromodulation and Cardiac Rhythm Management. Our three reportable segments correspondAdvanced Circulatory Support, corresponding to our Business Franchisesprimary business units. Other includes corporate shared service expenses for finance, legal, human resources, information technology and each Business Franchise corresponds to onecorporate business development. For 2021, other also includes the results of our three main therapeutic areas aligned to best serve our customers. Corporate activities include corporateHeart Valves business, development (“New Ventures”). New Ventures is focusedwhich was disposed of on new growth platforms and identification of other opportunities for expansion and investment.June 1, 2021.
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 Surgery UpdateCardiopulmonary
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 Cardiopulmonary segment 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, withdevelopment, production and sale of cardiopulmonary products, including oxygenators, heart-lung machines, autotransfusion systems, perfusion tubing systems, cannulae and other related accessories.
Information on Cardiopulmonary that could potentially impact our condensed consolidated financial statements and related disclosures is incorporated by reference to Part I. Note 7. Commitments and Contingencies: FDA Warning Letter, and Part I. Note 7. Commitments and Contingencies: Product Liability.
Neuromodulation
Our Neuromodulation segment designs, develops and markets devices that deliver neuromodulation therapy to treat DRE, and DTD. It encompasses 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.
In early February 2016, we announced that we received FDA approvaldevelopment and management of clinical testing of our CROWN PRTvalveaura6000 System for treating OSA, a device that stimulates 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 valvehypoglossal nerve, which in turn, engages certain muscles in the U.S. later this year.
In March 2017, we committedtongue in order to open the airway while 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, 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 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 alertpatient 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, 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,sleeping, 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 Control and Prevention (“CDC”) and 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, 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. 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, 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, the product remediation liability was $30.2 million. Refer to “Note 4. Product Remediation Liability” for additional information.


Litigation
On February 12, 2016, LivaNova was alerted that 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 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.
Neuromodulation Update
Epilepsy
Our product development efforts are directed toward improving the VNS Therapy System and developing new products that provide additional features and functionality. 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 is focused on the development and clinical testing of the VITARIA®VITARIA System for treating heart failure throughby stimulating the right vagus nerve stimulation.nerve.
We received CE Mark approvalDTD RECOVER Study
In March 2022, LivaNova announced the 250th unipolar depression patient has been implanted in the RECOVER clinical study. The study is designed with frequent interim analyses to be conducted by an independent Statistical Analysis Committee. The interim analyses will assess if predictive probability of success has been reached for the unipolar cohort of 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 method of VNS called autonomic regulation therapy (“ART”), and it includes the same elements as 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 conducted 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 Systemstudy.
Advanced Circulatory Support
Our Advanced Circulatory Support segment is not approvedengaged in the U.S. During 2014, we also initiateddevelopment, production and sale of leading-edge temporary life support products. These products include cardiopulmonary and respiratory support solutions consisting of temporary life support controllers and product kits that can include a second pilot study, ANTHEM-HFpEF,combination of pumps, oxygenators, and cannulae.
Advanced Circulatory Support products simplify temporary extracorporeal cardiopulmonary life support solutions for critically ill patients. Built around a common compact console and pump, LifeSPARC provides temporary support for emergent rescue patients in a variety of settings. Designed for ease of use, the system offers power and versatility for multi-disciplinary programs to study ARTsupport more patients in patients experiencing symptomatic heart failure with preserved ejection fraction. This pilot studymore places. The system 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,accompanied by four specialized 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 planready-to-deploy kits, each designed to enable commercialization of the Caisson technology.support diverse cannulation strategies.
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.
Significant Accounting Policies and Critical Accounting Estimates 
There have been no material changes toFor a discussion of our critical accounting policies from the information provided in “Part II, Item 7. Management’sestimates, see “Management’s Discussion and Analysis of Financial Condition and Results of Operations” that is included in our 2016the 2021 Form 10-K.
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. New Accounting Pronouncements” contained in the condensed consolidated financial statements in this Quarterly Report on Form 10-Q.
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Other
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. 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 will ensue from Brexit 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 Sates, and our parent company, LivaNova PLC, 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, Brexit 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.
The Trump Administration has included as part of its agenda a potential reform of U.S. tax laws.  On September 27, 2017, the White House released its “Unified Framework for Fixing Our Broken Tax Code” (the “Framework”), which was developed by the Trump Administration, the House Committee on Ways and Means, and the Senate Committee on Finance and which includes specific goals for lower business 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 at this time.



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, as compared to the three and nine months ended September 30, 2016.
The following table summarizes our condensed consolidated results of operations (in thousands):
Three Months Ended March 31,
2022
2021 (1)
Net sales$240,175 $247,603 
Cost of sales71,732 84,195 
Gross profit168,443 163,408 
Operating expenses:
Selling, general and administrative118,525 115,681 
Research and development40,918 44,625 
Other operating expenses(505)8,800 
Operating income (loss)9,505 (5,698)
Interest expense(7,840)(15,936)
Foreign exchange and other gains/(losses)3,904 (6,443)
Income (loss) before tax5,569 (28,077)
Income tax expense2,537 2,644 
Losses from equity method investments(39)(40)
Net income (loss)$2,993 $(30,761)
(1)The condensed consolidated results for the three months ended March 31, 2021 have been revised. For further details refer to “Note 1. Unaudited Condensed Consolidated Financial Statements.”
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  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)



Net Sales
The table below illustratespresents net sales by operating segment and market geographygeographic region (in thousands, except for percentages):
Three Months Ended March 31,
20222021% Change
Cardiopulmonary
United States$38,096 $35,759 6.5 %
Europe32,067 30,626 4.7 %
Rest of World46,912 42,334 10.8 %
117,075 108,719 7.7 %
Neuromodulation
United States87,210 82,300 6.0 %
Europe12,456 11,679 6.7 %
Rest of World10,561 9,720 8.7 %
110,227 103,699 6.3 %
Advanced Circulatory Support
United States10,963 12,560 (12.7)%
Europe603 228 164.5 %
Rest of World117 204 (42.6)%
11,683 12,992 (10.1)%
Other (1)
United States— 2,717 (100.0)%
Europe— 8,284 (100.0)%
Rest of World1,190 11,192 (89.4)%
1,190 22,193 (94.6)%
Totals
United States136,269 133,336 2.2 %
Europe (2)
45,126 50,817 (11.2)%
Rest of World58,780 63,450 (7.4)%
Total$240,175 $247,603 (3.0)%
(1)For 2021, other primarily includes the net sales of the Company’s Heart Valves business, which was disposed of on June 1, 2021.
(2)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.”

34


  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,  
  2017 2016 % Change
Cardiac Surgery      
United States $129,160
 $133,995
 (3.6)%
Europe (1)
 126,028
 128,229
 (1.7)%
Rest of world 202,424
 190,788
 6.1%
  457,612
 453,012
 1.0%
Neuromodulation      
United States 231,350
 220,892
 4.7%
Europe (1)
 25,500
 24,208
 5.3%
Rest of world 18,340
 15,801
 16.1%
  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%
(1)Includes those countries in Europe where LivaNova has a direct sales presence. Countries where sales are made through distributors are included in ‘Rest of world’.


The table below illustratespresents segment income (loss) from operations (in thousands)thousands, except for percentages):
Three Months Ended March 31,
2022
2021 (1)
% Change
Cardiopulmonary$6,895 $1,442 378.2 %
Neuromodulation37,478 34,083 10.0 %
Advanced Circulatory Support(5,438)2,393 (327.2)%
Other (2)
(23,082)(30,195)(23.6)%
Total reportable segment income (3)
$15,853 $7,723 105.3 %
  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 %
(1)
For a reconciliation of segment operating(1)Segment income to consolidated operating income refer to “Note 14. Geographic and Segment Information” in the condensed consolidated financial statements in this Quarterly Report on Form 10-Q.
Cardiac Surgery net sales increased by 7.6% and 1.0% for the three and nine months ended September 30, 2017, asMarch 31, 2021 has been revised. For further details refer to “Note 1. Unaudited Condensed Consolidated Financial Statements.”
(2)Other includes corporate shared service expenses for finance, legal, human resources, information technology and corporate business development. For 2021, other also includes the results of the Company’s Heart Valves business, which was disposed of on June 1, 2021.
(3)For a reconciliation of segment income to income (loss) before tax refer to “Note 12. Geographic and Segment Information” in the condensed consolidated financial statements in this Quarterly Report on Form 10-Q.
Cardiopulmonary
Cardiopulmonary net sales for the three months ended March 31, 2022 compared to the three and nine months ended September 30, 2016, respectively. NetMarch 31, 2021 increased 7.7% to $117.1 million primarily driven by oxygenator sales increased $11.3due to an increase in cardiac surgery procedure volumes and heart-lung machine sales in the Rest of World region, partially offset by the unfavorable impact of approximately $5 million due to foreign currency fluctuations.
Cardiopulmonary segment income for the three months ended March 31, 2022 was $6.9 million as compared to $1.4 million for the three months ended September 30, 2017,March 31, 2021. The increase in segment income was primarily due to an increase in sales, as discussed above, as well as a decrease in the litigation provision related to our 3T Heater-Cooler device and related legal costs.
Neuromodulation
Neuromodulation net sales for the three months ended March 31, 2022 compared to the three months ended March 31, 2021 increased 6.3% to $110.2 million due to growth across all regions driven by replacement implants.
Neuromodulation segment income for the three months ended March 31, 2022 was $37.5 million as compared to the prior-year period due to growth in both cardiopulmonary product revenue and heart valve revenue and favorable foreign currency exchange rate fluctuations. Cardiopulmonary sales increased 7.6%, or $8.7$34.1 million for the three months ended September 30, 2017,March 31, 2021. The increase in segment income was primarily due to strengthan increase in heart-lung machinessales, as discussed above, as well as the net impact of the change in fair value of the sales-based and milestone-based contingent consideration arrangement associated with the acquisition of ImThera of $3.5 million. These increases in operating income were partially offset by increases in R&D expenses for the three months ended March 31, 2022 compared to the three months ended March 31, 2021 totaling $2.6 million associated with our RECOVER clinical trial and OSPREY clinical study.
Advanced Circulatory Support
Advanced Circulatory Support net sales for the three months ended March 31, 2022 compared to the three months ended March 31, 2021 decreased 10.1% to $11.7 million primarily due to a resultreduction in patients treated with extracorporeal membrane oxygenation (ECMO) related to hospital staffing shortages and less severe COVID-19 cases.
Advanced Circulatory Support segment operating loss for the three months ended March 31, 2022 was $5.4 million as compared to segment income of geographic sales expansion and continued progress towards upgrading customers from older machines to our current S5 device. Heart valve sales increased by 7.7%, or $2.6$2.4 million for the three months ended September 30, 2017, as compared to the prior-year period due primarily to increased demand for the Perceval sutureless tissue valveMarch 31, 2021. The decrease 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 period due to heart-lung machine sales expansion outside of the U.S. and Europe. Cardiac Surgery operatingsegment income for the three months ended September 30, 2017 increased 33.8% over the prior-year period 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 sales 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, our new generation VNS Therapy System, which launched in October 2017. Thean 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 sales 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 expenses largely associated with business development costs driven by reductionsrelated to the acquisition of ALung. For additional information, please refer to “Note 14. Subsequent Event” in the overallcondensed consolidated financial statements in this Quarterly Report on Form 10-Q. Additionally, we incurred an increase in 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 recognizedmarketing expenses 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, asMarch 31, 2022 compared to the prior-year period, primarilythree months ended March 31, 2021. Sales and marketing expenses in 2021 were reduced as a result of lower commercial related and discretionary spending due to $3.9 million of Caisson related expenses and $12.9 millionCOVID-19. The decrease in increased Corporate costs. Operating loss from Other increased $30.3 million for the nine months ended September 30, 2017,segment income was also impacted by a decline in net sales, 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.discussed above.

35


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 %


Three Months Ended March 31,
20222021Change
Cost of sales29.9 %34.0 %(4.1)%
Selling, general and administrative49.3 %46.7 %2.6 %
Research and development17.0 %18.0 %(1.0)%
Other operating expenses(0.2)%3.6 %(3.8)%
Cost of Sales
Cost of sales consistedconsists 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 improvementwas 29.9% for the three months ended September 30, 2017 reflects management’s focus on cost efficienciesMarch 31, 2022, a decrease of 4.1% compared to improve gross margin. The cost improvement for the ninethree months ended September 30, 2017March 31, 2021. The decrease was primarily due to inventory fair value step-up amortization infavorable product mix, partially due to the prior year, which accounted for 3.9%sale of the decrease in our costHeart Valves business during the second quarter of sales as a percentage of net sales,2021, as well as the previously mentioned cost efficiencies. The total amount recognized for amortizationnet impact of the change in fair value step-up in inventoryof a sales-based contingent consideration arrangement of $1.9 million for the ninethree months ended September 30, 2016 was $35.2 million. The fair value step-up in inventory basis was fully amortized by September 30, 2016.March 31, 2022 compared to the three months ended March 31, 2021.
Sales,Selling, General and Administrative (“SG&A”) Expenses
SG&A expenses consistedare comprised of sales, marketing, and 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%, aswas 49.3% for the three months ended March 31, 2022, an increase of 2.6% compared to the prior-year period, andthree months ended March 31, 2021. The increase was consistent at 38.6%primarily due to business development expenses related to the acquisition of ALung. For additional information, please refer to “Note 14. Subsequent Event” in the condensed consolidated financial statements in this Quarterly Report on Form 10-Q. Additionally, 3T legal costs increased $1.5 million for the ninethree months ended September 30, 2017, asMarch 31, 2022 compared to the prior-year period. The 2.1% increase was largely attributable to litigation related to our 3T devices and other legal matters.three months ended March 31, 2021.
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 DTD, OSA and heart failure.
R&D expenses as a percentage of net sales was consistentwere 17.0% for the three months ended September 30, 2017, asMarch 31, 2022, a decrease of 1.0% compared to the prior-year period, and increased by 1.0% to 11.4% for the ninethree months ended September 30, 2017, as compared to the prior-year period.March 31, 2021. The increase isdecrease was primarily due to a decrease in R&D expense of $3.5 million resulting from 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 retentionsale 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,Heart Valve business on June 1, 2021, as well as changes in the integrationfair value of internal controlsmilestone-based contingent consideration arrangements of $2.0 million, partially offset by increases in R&D expenses of $2.6 million related to DTD and OSA.
Other Operating Expenses
Other operating expenses primarily consists of the provision for the two legacy organizations. In addition, integration expenses include retention bonuses, brandinglitigation involving our 3T Heater-Cooler device, restructuring expense, and renaming efforts and lease cancellation penalties in Milan and Brussels.
Mergermerger and integration expense.
Other operating expenses as a percentage of net sales decreased by 1.9% to 0.7%was (0.2)% for the three months ended September 30, 2017 asMarch 31, 2022, a decrease of 3.8% compared to the prior-year period, andthree months ended March 31, 2021. The decrease was primarily due to a decline in restructuring expenses of $6.2 million. Additionally, other operating expenses decreased by 1.5%$3.4 million from a decrease in the litigation provision related to 0.8%our 3T Heater-Cooler device for the ninethree months ended September 30, 2017 asMarch 31, 2022 compared to the prior-year period. These decreases were duethree months ended March 31, 2021. For additional information, please refer to a continued decline“Note 7. Commitments and Contingencies” in integration activities.the condensed consolidated financial statements in this Quarterly Report on Form 10-Q.
Restructuring ExpensesInterest Expense
Restructuring expenses were primarily due to our efforts under our 2015 and 2016 Reorganization Plans and the Suzhou, China exit plan, to leverage economies of scale, eliminate duplicate corporate expenses and streamline distributions, logistics 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%Interest expense for the three and nine months ended September 30, 2017, respectively, asMarch 31, 2022 was $7.8 million compared to the prior-year periods due to a continued decline in restructuring activities.
Gain on Caisson Acquisition
On May 2, 2017, we acquired the remaining 51% equity interests in Caisson which we previously accounted for under the equity method. On the acquisition date, we remeasured our notes receivable due from Caisson and our existing investment in Caisson 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$15.9 million for the three months ended September 30, 2017 and September 30, 2016, respectively. The gains wereMarch 31, 2021, primarily due to netthe repayment of the Company’s 2020 senior secured term loan during the third quarter of 2021. For further details, refer to “Note 5. Financing Arrangements” in the condensed consolidated financial statements in this Quarterly Report on Form 10-Q.
36


Foreign Exchange and Other Gains/(Losses)
Foreign exchange and other gains/(losses) consist primarily of gains and losses arising from transactions denominated in a currency different from an entity’s functional currency, foreign currency exchange rate derivative gains associated with foreign currency commercial transactions, freestanding foreign currency forward contracts, intercompany debt, and third-party financial assetslosses and liabilities. The gainschanges in the fair value of $1.0embedded and capped call derivatives.
Foreign exchange and other gains/(losses) was a gain of $3.9 million for the ninethree months ended September 30, 2017 includedMarch 31, 2022 as compared to a $3.2loss of $6.4 million gainfor the three months ended March 31, 2021. For further details, refer to “Note 13. Supplemental Financial Information” in the condensed consolidated financial statements in this Quarterly Report 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 million.


Form 10-Q.
Income Taxes
LivaNova PLC is domiciled and resident in the UK.UK for tax purposes. 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 of various tax strategies and the changes in tax laws, our consolidatedOur effective income tax rate may vary from one reporting period to another.
During the three and nine months ended September 30, 2017, we recorded consolidatedfluctuates based on, among other factors, changes in pretax income tax expense of $1.9 million and $10.9 million, respectively,in countries with consolidated effective incomevarying statutory tax rates, of 6.1%valuation allowances, tax credits and 9.3%, respectively.incentives, and unrecognized tax benefits associated with uncertain tax positions.
Our consolidated effective income tax rate for the three and nine months ended September 30, 2017 included the impact of various 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 itemsMarch 31, 2022 was 45.6% compared with (9.4)% for the ninethree 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 associatedMarch 31, 2021. Compared 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. TheMarch 31, 2021, the change in the effective tax rate for the ninethree months ended September 30, 2016March 31, 2022 was impacted byprimarily attributable to changes in the recording of valuation allowances of $23.9 million relatedand changes in income before tax in countries with varying statutory tax rates as compared to certain tax jurisdictions, including Francechanges in valuation allowances 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 millionother discrete items 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.March 31, 2021.
Liquidity and Capital Resources
Based on our current business plan, we believe that our existingsources of liquidity, which primarily consist of cash and cash equivalents, future cash generated from operations and available borrowing capacityborrowings under our creditcurrent debt facilities, will be sufficient to fund our uses of liquidity, primarily consisting of purchase obligations for expected operating, needs, working capital requirements,and R&D opportunities,needs, capital expenditures, acquisitions, and debt service requirements over the next 12 months. We regularly reviewtwelve-month period beginning from the issuance date of these condensed consolidated financial statements. From time to time, we may decide to access debt and/or equity markets to optimize our capital needsstructure, raise additional capital or increase liquidity as necessary, including to refinance our Bridge Loan Facility and consider various investingsatisfy liabilities that may arise in connection with the SNIA litigation. Our liquidity could be adversely impacted by the factors affecting future operating results, including those referred to in “Part I, Item 1A. Risk Factors” in the 2021 Form 10-K as supplemented by the factors referred to in “Part II, Item 1A. Risk Factors” in this Quarterly Reports on Form 10-Q as well as “Note 7. Commitments and Contingencies” in the condensed consolidated financial statements in this Quarterly Report on Form 10-Q.
37


Our operating, working capital and R&D purchase obligations primarily consist of liabilities arising from the normal course of business including inventory supply contracts, the future settlement of derivative instruments, and future payments of operating leases, as well as contingent consideration arrangements resulting from acquisitions, and obligations associated with legal and other accruals. The following table presents selected financial information related to our liquidity as of March 31, 2022 and December 31, 2021 (in thousands):
March 31, 2022December 31, 2021
Sources of liquidity
Cash and cash equivalents$128,737 $207,992 
Accounts receivable, net182,112 185,354 
Inventories114,844 105,840 
Short-term derivative assets (1)
82 106,629 
Long-term derivative assets (1)
96,717 — 
Availability under revolving credit facility (2)
125,000 125,000 
Short term uses of liquidity
Short-term derivative liabilities (1)
$1,928 $183,109 
Short-term debt (2)
4,752 229,673 
Short-term operating leases10,967 11,261 
Short-term contingent consideration (3)
11,268 11,552 
Short-term 3T litigation provision (4)
30,126 32,845 
Long-term uses of liquidity
Long-term debt (2)
$455,810 $9,849 
Long-term derivative liabilities (1)
170,660 — 
Long-term operating leases30,876 35,919 
Long-term contingent consideration (3)
83,341 86,830 
Long-term Saluggia site liability (4)
37,923 38,788 
Long-term 3T litigation provision (4)
6,105 6,625 
(1)For additional information, please refer to “Note 6. Derivatives and Risk Management” in the condensed consolidated financial statements in this Quarterly Report on Form 10-Q.
(2)For additional information, please refer to “Note 5. Financing Arrangements” in the condensed consolidated financial statements in this Quarterly Report on Form 10-Q.
(3)For additional information, please refer to “Note 4. Fair Value Measurements” in the condensed consolidated financial statements in this Quarterly Report on Form 10-Q.
(4)For additional information, please refer to “Note 7. Commitments and Contingencies” in the condensed consolidated financial statements in this Quarterly Report on Form 10-Q.
Significant Liquidity Matters
On February 21, 2022, the Court of Appeal notified the Company that it granted the Company a suspension with respect to the payment of damages in the amount of €453.6 million (approximately $503.1 million at March 31, 2022) in the SNIA litigation until a decision has been reached on our appeal to the Italian Supreme Court. This suspension was subject to providing the SNIA Litigation Guarantee of €270.0 million (approximately $299.5 million at March 31, 2022) within 30 calendar days.
On February 24, 2022, LivaNova PLC and its wholly-owned subsidiary, LivaNova USA, Inc., entered into the Bridge Loan Facility. On March 16, 2022, LivaNova delivered a borrowing notice for $220.0 million in connection with the Bridge Loan Facility, which was funded on March 17, 2022.
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On March 18, 2022, LivaNova PLC, acting through its Italian branch, entered into an Indemnity Letter and an Account Pledge Agreement with Barclays, further to which Barclays issued the €270.0 million SNIA Litigation Guarantee. As security for the SNIA Litigation Guarantee, LivaNova is required to grant cash collateral to Barclays in US dollars in an amount equal to the USD equivalent of 105% of the amount of the SNIA Litigation Guarantee calibrated on a biweekly basis. At March 31, 2022, the cash collateral totaled $313.6 million and is classified as Restricted Cash on the condensed consolidated balance sheet.
The proceeds of the Bridge Loan Facility were used by LivaNova to post a portion of the cash collateral supporting the SNIA Litigation Guarantee. The Bridge Loan Facility bears interest at an adjusted term SOFR, with a floor of 0.5%, plus 3.5% increasing by 0.25% 15 days after drawing and by an additional 0.5% 90 days after drawing and every 90 days thereafter, with a maximum margin of 5.25% over adjusted SOFR. The Bridge Loan Facility, which matures on June 16, 2023, will become a current liability at the end of the second quarter 2022, and is subject to mandatory prepayment in connection with certain asset dispositions, equity or debt issuance as well as in the event that collateral securing the SNIA Litigation Guarantee is released. At this point in time, the Company believes it can secure additional debt financing alternatives to support our requirements. replace the Bridge Loan Facility prior to its maturity in mid-2023. While the Company has been successful in raising capital in the past, there can be no assurances as to when the Company will be able to secure replacement financing or whether it can do so on terms acceptable to the Company, in a timely manner, if at all.
On March 21, 2022, LivaNova delivered the SNIA Litigation Guarantee as required by the Court of Appeal, thereby satisfying the condition to obtain the suspension for the payment of damages in connection with the SNIA litigation until review of such judgment by the Italian Supreme Court.
Refer to “Note 7.5. 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)debt 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. 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.


debt transactions.
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 and restricted cash were as follows (in thousands):
 Nine Months Ended September 30,Three Months Ended March 31,
 2017 2016 20222021
Operating activities $73,665
 $49,348
Operating activities$25,823 $19,480 
Investing activities (41,797) (36,363)Investing activities(5,482)(9,858)
Financing activities (10,000) (62,996)Financing activities214,877 (8,328)
Effect of exchange rate changes on cash and cash equivalents 3,501
 1,030
Net increase (decrease) $25,369
 $(48,981)
Effect of exchange rate changes on cash, cash equivalents and restricted cashEffect of exchange rate changes on cash, cash equivalents and restricted cash(826)(1,587)
Net increase (decrease) in cash, cash equivalents and restricted cashNet increase (decrease) in cash, cash equivalents and restricted cash$234,392 $(293)
Operating Activities
Cash provided by operating activities during the ninethree months ended September 30, 2017March 31, 2022 increased $24.3by $6.3 million as compared to the same prior-year period. The increase was primarily the result ofdue to an increase in net income adjusted for non-cash items of $119.6$23.4 million, largely driven by an increase in Neuromodulation and Cardiopulmonary net sales. This increase was partially offset by a $43.2 millionnet change in operating assets and liabilities,working capital of $17.1 million, largely attributable to the receipt of a $39.4CARES Act tax refund of $24.5 million gain recognized in conjunction withduring the acquisitionfirst quarter of Caisson and2021 compared to the receipt of a $17.0CARES Act tax refund of $6.7 million increase in deferred income tax benefit.during the three months ended March 31, 2022.
Investing Activities
Cash used in investing activities during the ninethree months ended September 30, 2017 increased $5.4March 31, 2022 decreased $4.4 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-yearprior year period offset by $7.1 millionlargely due to a decline in purchases of short-term investments in the prior-year period.property, plant and equipment of $3.0 million.
Financing Activities
Cash used inprovided by financing activities during the ninethree months ended September 30, 2017 decreased $53.0March 31, 2022 increased $223.2 million as compared to the same prior-year period. The decrease wasprior year period primarily the result of a decrease indue to net debt repayments of $27.5 million, a decrease in share repurchases of $11.1 million and the repayment of trade receivable advances of $23.8 million in the prior-year period, offset by a reduction in proceeds from stock option exercisesborrowings under the Bridge Loan Facility of $4.7$218.3 million.
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, equity price risk, 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
39


financing activities and, at certain times, derivative financial instruments. Quantitative and qualitative disclosures about these risks are included in this Quarterly Report on Form 10-Q in “Part I, Note 8”,6. 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”, and in our 20162021 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”. There have been no material changes from the information provided therein.Factors.”
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, under the supervision and with the participation of our CEO and CFO, evaluated the effectiveness of the design and operation of our disclosure controls and procedures as of the end of the most recent fiscal quarter reported herein. Based on that evaluation, our CEO and CFO concluded that our disclosure controls and procedures were effective as of September 30, 2017.


March 31, 2022.
(b) Changes in Internal Control Over Financial Reporting
We deployed 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. Our internal controls have been updated to reflect these changes. There have been no other changesNo change in our internal control over financial reporting (as defined in Rules 13a-15(f) and 15d-5(f) under the Exchange Act) occurred during the period covered by this Quarterly Report on Form 10-Qquarter ended March 31, 2022 that havehas materially affected, or areis reasonably likely to materially affect, our internal control over financial reporting.

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PART II. OTHER INFORMATION
Item 1. Legal Proceedings
For a description of our material pending legal and regulatory proceedings and settlements, refer to “Note 9.7. Commitments and Contingencies” in our condensed consolidated financial statements included in this Quarterly Report on Form 10-Q.
Item 1A. RISKFACTORSRiskFactors
Our business faces many risks. Any of the risks referencedOther than as described below, or elsewherethere have been no material changes in thisour risk factors from those disclosed in Part I, Item 1A to our 2021 Annual Report on Form 10-Q,10-K.
Reductions or interruptions in the supply of the materials and components used in manufacturing our products may adversely affect our financial condition and business operations, particularly in the wake of COVID-19.
We maintain manufacturing operations in five countries located throughout the world and purchase many of the components and raw materials used in manufacturing these products from numerous suppliers in various countries. Any problem affecting a supplier (whether due to external or internal causes) could have a negative impact on us. Difficulties and delays in manufacturing, internally or through third-party providers or otherwise within the supply chain, may lead to voluntary or involuntary business interruptions or shutdowns, product shortages, withdrawals or suspensions of products from the market, and potential regulatory action.
In some cases, we purchase specific components and raw materials from primary or main suppliers (or in some cases, a single or sole supplier) for reasons related to quality assurance, cost-effectiveness and availability. While we work closely with our suppliers to ensure supply continuity, minimize the instances in which we rely on a sole supplier and take other Reportscountermeasures to reduce our supply chain risk, we cannot guarantee that our efforts will always be successful. Moreover, due to strict standards and regulations governing the manufacture and marketing of our products, we may not be able to locate new supply sources quickly or at all in response to a supply reduction or interruption, with negative effects on Form 10-Qs or our ability to manufacture our products effectively and timely.
The COVID-19 pandemic has exacerbated this risk by, among other SEC filingsthings, causing global supply chain shortages. Like many companies, for example, we are experiencing supply chain delays and interruptions, labor shortages, inflationary pressures and logistical issues in the wake of COVID-19. Though, to date, our supply of raw materials and the production and distribution of finished products have not been materially affected, demand and low capacity worldwide have caused longer lead times and put price pressure on key raw materials. Moreover, freight and labor costs at our manufacturing facilities have increased in the wake of inflation globally. We are managing our supply chain by giving long visibility to our suppliers, conducting regular supply critical risk reviews and closely monitoring our inventory, among other things, but any problem could quickly, negatively reverberate throughout the organization. To the extent we are unsuccessful in managing our supply chain, any such issues could have a material impactadverse effect on our business, and consolidated financial position or results of operations. Additional risksoperations, financial condition, cash flows and uncertainties not presently knownrecoverability of our tangible and intangible assets.
Failure to us or that we currently believe to be immaterialcomply with product-related government regulations may also impairmaterially adversely affect our financial condition and business operations.
Both before and after a product is commercially released, we have ongoing responsibilities under FDA and other applicable non-U.S. government agency regulations. For additional detailed discussioninstance, many of our facilities and procedures and those of our suppliers are subject to periodic inspections by the FDA, which can result in inspectional observations on FDA’s Form-483, warning letters, or other forms of enforcement. If the FDA were to conclude that we are not in compliance with applicable laws or regulations, or that any of our medical products are ineffective or pose an unreasonable health risk, factorsthe FDA could ban such medical products, detain or seize adulterated or misbranded medical products, order a recall, repair, replacement, or refund of such products, refuse to grant pending PMA applications or require certificates of non-U.S. governments for exports, and/or require us to notify health professionals and others that shouldthe devices present unreasonable risks of substantial harm to the public health. In 2015, we received a warning letter from the FDA alleging certain violations of FDA regulations, which resulted in certain devices that were manufactured in Munich, Germany, to be understooddenied admission to the U.S. until resolution of the issues set forth by any investor contemplating investmentthe FDA in the warning letter. In April 2022, a Form 483 was issued at the conclusion of the FDA’s inspection of our stock, please refer to “Part I. Item 1A. Risk Factors” in our 2016 Form 10-KGermany facility. See “Note 7. Commitments and elsewhere as describedContingencies” in this ReportForm 10-Q for additional information.
If the FDA does not agree with the proposed corrective or preventive actions in the response to the Form 483, or accepts them but finds that we have not implemented them adequately, or if we otherwise fail to comply with applicable regulatory requirements, the FDA could decide not to close out the 2015 Warning Letter based on the most recent inspection, even if they agree with our most recent Form 10-Q.483 response. In addition, the FDA could require that a successful re-inspection be completed
The results of
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in the UK’s referendum on withdrawal fromfuture in order to close out that Warning Letter and/or the EU may have a negative effect on global economic conditions, financial markets and our business, which could reducemost recent inspection. As we continue to work with 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 referredFDA, we remain subject 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 UK2015 Warning Letter, which subjected our legacy 3T devices to refusal of admission into the U.S. and which stated that premarket approval applications for Class III devices to which certain Quality System regulation deviations identified in the Warning Letter were reasonably related would not be approved until the violations had been corrected; however, with clearance for K191402, 3T devices manufactured in accordance with K191402 are not subjected to the import alert and the EU. The withdrawal must occur within two years, unlesspremarket approval restriction applied only to the deadline is extendedMunich and Arvada facilities, which do not manufacture or a withdrawal agreement is negotiated sooner. The negotiation process will determinedesign devices subject to Class III premarket approval.
While we work diligently to manage our ongoing responsibilities, the future terms of the UK’s relationship with the EU. The notification does not change the application of existing tax laws,FDA 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 ifother non-U.S. government agencies could assess civil 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 affectcriminal penalties against us, our customers, suppliers, vendors,officers or employees and impose operating restrictions on a company-wide basis. The FDA could also recommend prosecution to the U.S. Department of Justice. An adverse regulatory action could restrict us from effectively marketing and selling our industry.
Several ofproducts, limit our wholly-owned subsidiaries that are domiciled eitherability to obtain future pre-market clearances or PMAs, and result 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 applicablea substantial modification to our transactionsbusiness practices 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 UKoperations. These potential consequences, as well as any adverse outcome from the EU maygovernment investigations, could have a material adverse impacteffect on our future financial results andbusiness, results of operations.operations, financial condition, and cash flows.
In addition, in the U.S., device manufacturers are prohibited from promoting their products other than for the uses and indications set forth in the approved product labeling (so called “off-label uses”). Our VNS Therapy System, for example, is indicated in the U.S., as an adjunctive therapy in reducing the frequency of seizures in patients 4 years of age and older with partial onset seizures that are refractory to antiepileptic medications, yet a number of physicians elect to prescribe our device for certain patients suffering from generalized seizures. While physicians may exercise their discretion in prescribing a device off-label, any failure on the part of the device manufacturer to comply with off-label regulations could subject us to significant civil or criminal exposure, administrative obligations and costs, and/or other potential penalties from, and/or agreements with, the federal government.
Governmental regulations outside the U.S. have, and may continue to become, increasingly stringent and common. In the EU, for example, Reg MDR (Medical Device Regulation) became effective in May 2021, resulting in significant additional premarket and post-market requirements which must be in place by May 2024. During this transition period, the two-year negotiation period, European Commission is allowing companies to use their MDD (Medical Device Directive) certifications. LivaNova is working to obtain all appropriate approvals and intends to be fully compliant by the May 2024 deadline, as penalties for regulatory non-compliance can be severe, including fines and revocation or suspension of a company’s business license, mandatory price reductions and criminal sanctions.
We will monitorare subject to the risks of conducting business internationally.
We develop, manufacture, distribute and sell our products globally, and we intend to continue to pursue growth opportunities worldwide. Our international operations are subject to risks that are inherent in conducting business globally and under non-U.S. laws, regulations and customs. These risks include possible nationalization, invasions, wars, negative consequences associated with Brexit, expropriation, importation limitations, pricing restrictions, government shutdowns and violations of laws, and the resulting issues from any such risks. In February 2022, for example, Russia launched an invasion in Ukraine which caused us to assess our ability to sell in the market due to international sanctions, to consider the potential impact of this eventraw material sourced from the region, and explore possible tax-planning strategies that may mitigate to determine whether we are able to transact in a compliant fashion. Although the region represented 1% of our total net sales for 2021, the Russian invasion of Ukraine has increased economic uncertainties, and a significant escalation and/or eliminate any suchcontinuation of the conflict could have a material, global impact on our operating results. In addition, our Russian employees and local subsidiary are subject to evolving laws and regulations imposed by the Russian authorities in response to international sanctions. Our profitability and operations are, and will continue to be, subject to a number of risks and potential adverse impact. We will not account for the impact of Brexitcosts, including: local product preferences and product requirements; longer-term receivables than are typical in our income tax provisions until changes in tax laws or treaties between the UK and the EU or individual EU Member States are enactedthe U.S.; difficulty enforcing agreements; creditworthiness of customers; trade protection measures and import and export licensing requirements; imposition of sanctions; different labor regulations and workforce instability; higher danger of terrorist activity, war or civil unrest; selling our products through distributors and agents; and political and economic instability. Any of 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 materiallyaforementioned risks could adversely affect our consolidated earnings,business, results of operations, financial condition, and/orconditions and cash flows. Caisson
From time to time, certain of our subsidiaries have limited business dealings in countries subject to comprehensive sanctions, including Iran, Sudan, Syria and now Russia. These business dealings represent an insignificant amount of our consolidated revenues and income, but expose us to a heightened risk of violating applicable sanctions regulations. Violations of these regulations are punishable by civil penalties including fines, denial of export privileges, injunctions, asset seizures, debarment from government contracts and revocations or restriction of licenses, as well as criminal fines and imprisonment. We have established policies and procedures designed to assist with our compliance with such laws and regulations, but there can be no
42


assurance that our policies and procedures will prevent us from violating these regulations in every transaction in which we may engage, and such a violation could adversely affect our reputation, business, results of operations, financial conditions and cash flows.
Our functional currency is the U.S. dollar; however, a portion of 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. For transactions denominated in currencies other than our functional currencies, fluctuations in the early stagesexchange rate will impact our results 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 failurefinancial condition. Although we may elect to manage and coordinate the growth of Caisson successfully could have an adverse impact on our business. In addition,hedge certain foreign currency exposure, we cannot be certain that the acquisitionhedging activity will become profitable eliminate our currency risk.
In addition, in many of the countries where we operate, employees are covered by various laws and/or remain so. These effects, individuallycollective bargaining agreements that endow them, through their local or national representatives, with the right to be consulted in relation to specific issues, including the aggregate,downsizing or closing of departments and staff reductions. The laws and/or collective bargaining agreements that are applicable to these agreements could causehave an impact on our flexibility, as they apply to programs to redefine and/or strategically reposition our activities. Our ability to implement staff downsizing programs or even temporary interruptions of employment relationships is predicated on the approval of government entities and the consent of labor unions. A negative response from a deterioration ofworks council or union-organized work stoppages by employees could have a negative impact on our credit rating and result in increased borrowing costs and interest expense.business.



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

Disclosure Pursuant to Section 13(r) of the Exchange Act of 1934

Section 13(r) of the Exchange Act requires issuers to disclose in their quarterly reports certain types of dealings with Iran, including transactions or dealings with government-owned entities, even when those activities are lawful and do not involve U.S. persons. One of our non-U.S. subsidiaries currently sells medical devices, including cardiopulmonary, cardiac surgery and neuromodulation products, to privately held distributors in Iran.
We have limited visibility into the identity of these distributors’ customers in Iran. It is possible that their customers include entities, such as government-owned hospitals or sub-distributors, that are owned or controlled directly or indirectly by the Iranian government. To the best of our knowledge at this time, we do not have any contracts or commercial arrangements with the Iranian government.
Our gross revenues and net profits attributable to the above-mentioned Iranian activities were $1.8 million and $0.9 million for the three months ended March 31, 2022, respectively.
We believe our activities are consistent with applicable law, including U.S., EU, and other applicable sanctions laws, though such laws are complex and continue to evolve rapidly. We intend to continue our business in Iran.

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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 exhibitsExhibits marked with the cross symbol (†), if any, are management contracts or compensatory plans or arrangements filed pursuant to Item 601(b)(10)(iii) of Regulation S-K.
Exhibit
Number
Document Description
Amendment 2 to the Credit Agreement, dated as of March 16, 2022, by and among LivaNova PLC, LivaNova USA, Inc., the Lenders and Goldman Sachs Bank USA as First Lien Administrative Agent
Letter of indemnity in respect of the issuance of Trade Finance guarantee by Barclays Bank Ireland PLC, Italy Branch dated March 18, 2022, by and among LivaNova PLC Italian Branch and Barclays Bank Ireland PLC, Italy Branch, incorporated by reference to Exhibit 10.1 of the Company’s Current Report on Form 8-K, filed on March 21, 2022
Pledge Agreement dated as of March 18, 2022, among LivaNova PLC Italian Branch and Barclays Bank Ireland PLC, Italy Branch, incorporated by reference to Exhibit 10.2 of the Company’s Current Report on Form 8-K, filed on March 21, 2022
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 formatted in Inline XBRL: (i) the Condensed Consolidated Statements of Income (Loss) for the three months ended March 31, 2022 and 2021, (ii) the Condensed Consolidated Statements of Comprehensive Income (Loss) for the three months ended March 31, 2022 and 2021, (iii) the Condensed Consolidated Balance Sheet as of March 31, 2022 and December 31, 2021, (iv) the Condensed Consolidated Statements of Cash Flows for the three months ended March 31, 2022 and 2021, and (vi) the Notes to the Condensed Consolidated Financial Statements
104*Cover Page Interactive Data File (formatted as Inline XBRL and contained in Exhibit 101)
44
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.     





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
LIVANOVA PLC
Date: May 4, 2022By:
By:/s/ DAMIEN MCDONALD
Damien McDonald
Chief Executive Officer
(Principal Executive Officer)
LIVANOVA PLC
LIVANOVA PLC
Date: May 4, 2022By:/s/ ALEX SHVARTSBURG
By:/s/ THAD HUSTONAlex Shvartsburg
Thad Huston
Chief Financial Officer
(Principal Accounting and Financial Officer)
Date: November 2, 2017


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