Rockwell Medical (RMTI) 10-Q 15 Nov 21 2021 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2021	Nov. 12, 2021
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2021
Document Transition Report	false
Entity File Number	000-23661
Entity Registrant Name	ROCKWELL MEDICAL, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	38-3317208
Entity Address, Address Line One	30142 S. Wixom Road
Entity Address, City or Town	Wixom
Entity Address, State or Province	MI
Entity Address, Postal Zip Code	48393
City Area Code	248
Local Phone Number	960-9009
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Title of 12(b) Security	Common Stock, par value $0.0001
Trading Symbol	RMTI
Security Exchange Name	NASDAQ
Entity Common Stock, Shares Outstanding (in shares)		93,966,381
Entity Central Index Key	0001041024
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q3

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
ASSETS
Cash and Cash Equivalents	$ 23,390	$ 48,682
Investments Available-for-Sale	9,813	9,997
Accounts Receivable, net	6,036	4,171
Inventory, net	4,028	3,913
Prepaid and Other Current Assets	2,815	2,706
Total Current Assets	46,082	69,469
Property and Equipment, net	2,507	2,642
Inventory, Non-Current	1,526	1,176
Right of Use Assets, net	6,934	2,911
Goodwill	921	921
Other Non-Current Assets	729	629
Total Assets	58,699	77,748
LIABILITIES AND STOCKHOLDERS’ EQUITY
Accounts Payable	4,834	4,155
Accrued Liabilities	4,371	5,013
Lease Liability - Current	1,832	1,167
Deferred License Revenue - Current	2,176	2,175
Term Loan - Net of Issuance Costs	7,131	0
Insurance Financing Note Payable	1,312	0
Customer Deposits	100	152
Other Current Liability - Related Party	0	131
Total Current Liabilities	21,756	12,793
Lease Liability - Long-Term	5,226	1,821
Term Loan, Net of Issuance Costs	14,094	20,949
Deferred License Revenue - Long-Term	6,529	8,015
Total Liabilities	47,605	43,578
Commitments and Contingencies (See Note 14)
Stockholders’ Equity:
Preferred Stock, $0.0001 par value, 2,000,000 shares authorized; no shares issued and outstanding at September 30, 2021 and December 31, 2020	0	0
Common Stock, $0.0001 par value; 170,000,000 shares authorized; 93,966,381 and 93,573,165 shares issued and outstanding at September 30, 2021 and December 31, 2020, respectively	9	9
Additional Paid-in Capital	372,168	371,510
Accumulated Deficit	(361,139)	(337,406)
Accumulated Other Comprehensive Income	56	57
Total Stockholders’ Equity	11,094	34,170
Total Liabilities and Stockholders’ Equity	$ 58,699	$ 77,748

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Sep. 30, 2021	Dec. 31, 2020
Statement of Financial Position [Abstract]
Preferred shares, par value (in dollars per share)	$ 0.0001	$ 0.0001
Preferred shares, shares authorized (in shares)	2,000,000	2,000,000
Preferred shares, shares issued (in shares)	0	0
Preferred shares, shares outstanding (in shares)	0	0
Common shares, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common shares, shares authorized (in shares)	170,000,000	170,000,000
Common shares, shares issued (in shares)	93,966,381	93,573,165
Common shares, shares outstanding (in shares)	93,966,381	93,573,165

UNAUDITED CONDENSED CONSOLIDATE

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Statement [Abstract]
Net Sales	$ 15,988	$ 15,280	$ 46,599	$ 47,033
Cost of Sales	16,317	14,934	46,788	44,693
Gross (Loss) Profit	(329)	346	(189)	2,340
Research and Product Development	1,221	1,745	5,445	5,183
Selling and Marketing	1,541	1,669	4,860	5,738
General and Administrative	3,881	3,622	11,483	11,767
Operating Loss	(6,972)	(6,690)	(21,977)	(20,348)
Other (Expense) Income
Realized (Loss) Gain on Investments	0	4	(1)	8
Warrant Modification Expense	0	0	0	(837)
Interest Expense	(609)	(666)	(1,772)	(1,289)
Interest Income	0	2	17	239
Total Other Expense	(609)	(660)	(1,756)	(1,879)
Net Loss	$ (7,581)	$ (7,350)	$ (23,733)	$ (22,227)
Basic Net Loss per Share (in dollars per share)	$ (0.08)	$ (0.10)	$ (0.26)	$ (0.32)
Diluted Net Loss per Share (in dollars per share)	$ (0.08)	$ (0.10)	$ (0.26)	$ (0.32)
Basic Weighted Average Shares Outstanding (in shares)	93,882,142	71,811,322	93,726,629	69,594,167
Diluted Weighted Average Shares Outstanding (in shares)	93,882,142	71,811,322	93,726,629	69,594,167

UNAUDITED CONDENSED CONSOLIDA_2

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Statement of Comprehensive Income [Abstract]
Net Loss	$ (7,581)	$ (7,350)	$ (23,733)	$ (22,227)
Unrealized Gain (Loss) on Available-for-Sale Debt Instrument Investments	4	2	(4)	(11)
Foreign Currency Translation Adjustments	0	1	3	8
Comprehensive Loss	$ (7,577)	$ (7,347)	$ (23,734)	$ (22,230)

UNAUDITED CONDENSED CONSOLIDA_3

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Bought Deal	Public Offering	At-the-Market Offering	COMMON STOCK	COMMON STOCKBought Deal	COMMON STOCKPublic Offering	COMMON STOCKAt-the-Market Offering	ADDITIONAL PAID-IN CAPITAL	ADDITIONAL PAID-IN CAPITALBought Deal	ADDITIONAL PAID-IN CAPITALPublic Offering	ADDITIONAL PAID-IN CAPITALAt-the-Market Offering	ACCUMULATED DEFICIT	ACCUMULATED OTHER COMPREHENSIVE INCOME
Beginning balance (in shares) at Dec. 31, 2019					65,378,890
Beginning balance at Dec. 31, 2019	$ 20,320				$ 7				$ 326,777				$ (306,516)	$ 52
Increase (Decrease) in Shareholders' Equity
Net Loss	(7,984)												(7,984)
Unrealized Gain (Loss) on Available-for-Sale Debt Instrument Investments	(7)													(7)
Foreign Currency Translation Adjustments	6													6
Issuance of common stock, net of offering costs (in shares)						3,670,212
Issuance of common stock, net of offering costs		$ 8,003								$ 8,003
Issuance of Warrants related to Debt Financing	501								501
Stock-based Compensation expense	935								935
Ending balance (in shares) at Mar. 31, 2020					69,049,102
Ending balance at Mar. 31, 2020	21,774				$ 7				336,216				(314,500)	51
Beginning balance (in shares) at Dec. 31, 2019					65,378,890
Beginning balance at Dec. 31, 2019	20,320				$ 7				326,777				(306,516)	52
Increase (Decrease) in Shareholders' Equity
Net Loss	(22,227)
Unrealized Gain (Loss) on Available-for-Sale Debt Instrument Investments	(11)
Foreign Currency Translation Adjustments	8
Ending balance (in shares) at Sep. 30, 2020					93,573,165
Ending balance at Sep. 30, 2020	42,075				$ 9				370,760				(328,743)	49
Beginning balance (in shares) at Mar. 31, 2020					69,049,102
Beginning balance at Mar. 31, 2020	21,774				$ 7				336,216				(314,500)	51
Increase (Decrease) in Shareholders' Equity
Net Loss	(6,893)												(6,893)
Unrealized Gain (Loss) on Available-for-Sale Debt Instrument Investments	(6)													(6)
Foreign Currency Translation Adjustments	1													1
Issuance of common stock, net of offering costs (in shares)								987,716
Issuance of common stock, net of offering costs				$ 1,978								$ 1,978
Vesting of Restricted Stock Units Issued, net of taxes withheld (in shares)					120,104
Vesting of Restricted Stock Units Issued, net of taxes withheld	(19)								(19)
Warrant Modification Expense	837								837
Stock-based Compensation expense	(1,461)								(1,461)
Ending balance (in shares) at Jun. 30, 2020					70,156,922
Ending balance at Jun. 30, 2020	16,211				$ 7				337,551				(321,393)	46
Increase (Decrease) in Shareholders' Equity
Net Loss	(7,350)												(7,350)
Unrealized Gain (Loss) on Available-for-Sale Debt Instrument Investments	2													2
Foreign Currency Translation Adjustments	1													1
Issuance of common stock, net of offering costs (in shares)							23,178,809	140,892
Issuance of common stock, net of offering costs			$ 32,677	$ 284			$ 2				$ 32,675	$ 284
Vesting of Restricted Stock Units Issued, net of taxes withheld (in shares)					96,542
Stock-based Compensation expense	250								250
Ending balance (in shares) at Sep. 30, 2020					93,573,165
Ending balance at Sep. 30, 2020	$ 42,075				$ 9				370,760				(328,743)	49
Beginning balance (in shares) at Dec. 31, 2020	93,573,165				93,573,165
Beginning balance at Dec. 31, 2020	$ 34,170				$ 9				371,510				(337,406)	57
Increase (Decrease) in Shareholders' Equity
Net Loss	(7,752)												(7,752)
Unrealized Gain (Loss) on Available-for-Sale Debt Instrument Investments	(7)													(7)
Foreign Currency Translation Adjustments	3													3
Stock-based Compensation expense (in shares)					26,354
Stock-based Compensation expense	(236)								(236)
Ending balance (in shares) at Mar. 31, 2021					93,599,519
Ending balance at Mar. 31, 2021	$ 26,178				$ 9				371,274				(345,158)	53
Beginning balance (in shares) at Dec. 31, 2020	93,573,165				93,573,165
Beginning balance at Dec. 31, 2020	$ 34,170				$ 9				371,510				(337,406)	57
Increase (Decrease) in Shareholders' Equity
Net Loss	(23,733)
Unrealized Gain (Loss) on Available-for-Sale Debt Instrument Investments	(4)
Foreign Currency Translation Adjustments	$ 3
Ending balance (in shares) at Sep. 30, 2021	93,966,381				93,966,381
Ending balance at Sep. 30, 2021	$ 11,094				$ 9				372,168				(361,139)	56
Beginning balance (in shares) at Mar. 31, 2021					93,599,519
Beginning balance at Mar. 31, 2021	26,178				$ 9				371,274				(345,158)	53
Increase (Decrease) in Shareholders' Equity
Net Loss	(8,400)												(8,400)
Unrealized Gain (Loss) on Available-for-Sale Debt Instrument Investments	(1)													(1)
Vesting of Restricted Stock Units Issued, net of taxes withheld (in shares)					211,862
Vesting of Restricted Stock Units Issued, net of taxes withheld	(7)								(7)
Stock-based Compensation expense	433								433
Ending balance (in shares) at Jun. 30, 2021					93,811,381
Ending balance at Jun. 30, 2021	18,203				$ 9				371,700				(353,558)	52
Increase (Decrease) in Shareholders' Equity
Net Loss	(7,581)												(7,581)
Unrealized Gain (Loss) on Available-for-Sale Debt Instrument Investments	4													4
Foreign Currency Translation Adjustments	0
Issued shares for services (in shares)					155,000
Issued shares for services	107								107
Stock-based Compensation expense	$ 361								361
Ending balance (in shares) at Sep. 30, 2021	93,966,381				93,966,381
Ending balance at Sep. 30, 2021	$ 11,094				$ 9				$ 372,168				$ (361,139)	$ 56

UNAUDITED CONDENSED CONSOLIDA_4

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Cash Flows From Operating Activities:
Net Loss	$ (23,733)	$ (22,227)
Adjustments To Reconcile Net Loss To Net Cash Used In Operating Activities:
Depreciation and Amortization	535	614
Stock-based Compensation	558	(276)
Warrant Modification Expense	0	837
Increase in Inventory Reserves	89	305
Amortization of Right of Use Asset	1,312	1,090
Amortization of Debt Financing Costs and Accretion of Debt Discount	276	200
Loss on Disposal of Assets	7	7
Realized Loss (Gain) on Sale of Investments Available-for-Sale	1	(8)
Foreign Currency Translation Adjustment	3	7
Changes in Assets and Liabilities:
(Increase) Decrease in Accounts Receivable, net	(1,865)	74
Increase in Inventory	(554)	(953)
Decrease in Prepaid and Other Assets	1,760	161
Increase in Accounts Payable	679	1,172
Decrease in Settlement Payable	0	(104)
Decrease in Lease Liability	(1,266)	(1,056)
(Decrease) Increase in Other Liabilities	(825)	423
Decrease in Deferred License Revenue	(1,485)	(1,338)
Changes in Assets and Liabilities	(3,556)	(1,621)
Cash Used In Operating Activities	(24,508)	(21,072)
Cash Flows From Investing Activities:
Purchase of Investments Available-for-Sale	(19,107)	(23,531)
Sale of Investments Available-for-Sale	19,286	27,076
Purchase of Equipment	(408)	(970)
Cash (Used In) Provided By Investing Activities	(229)	2,575
Cash Flows From Financing Activities:
Proceeds from Term Loan	0	22,500
Debt Issuance Costs	0	(1,343)
Payments on Short Term Note Payable	(656)	(763)
Proceeds from the Issuance of Common Stock for payment related to services provided	107	0
Repurchase of Common Stock to Pay Employee Withholding Taxes	(6)	(18)
Cash (Used In) Provided By Financing Activities	(555)	63,317
(Decrease) Increase in Cash and Cash Equivalents	(25,292)	44,820
Cash and Cash Equivalents at Beginning of Period	48,682	11,794
Cash and Cash Equivalents at End of Period	23,390	56,614
Supplemental Disclosure of Cash Flow Information:
Cash Paid for Interest	1,318	906
Supplemental Disclosure of Noncash Investing and Financing Activities:
Change in Unrealized Loss on Marketable Securities Available-for-Sale	(4)	(11)
Fair Value of Warrants issued related to Debt Financing	0	501
Public Offering
Cash Flows From Financing Activities:
Proceeds from the Issuance of Common Stock	0	43,148
Offering Costs from the Issuance of Common Stock	0	(2,469)
At-the-Market Offering
Cash Flows From Financing Activities:
Proceeds from the Issuance of Common Stock	0	2,325
Offering Costs from the Issuance of Common Stock	$ 0	$ (63)

Description of Business

Description of Business	9 Months Ended
	Sep. 30, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Description of Business	Description of Business Rockwell Medical, Inc. ("Rockwell Medical," "Rockwell", the "Company" or "We") is a commercial-stage, biopharmaceutical company developing and commercializing our next-generation parenteral iron technology platform, ferric pyrophosphate citrate (“FPC”), which we believe has the potential to lead to transformative treatments for iron deficiency in multiple disease states, reduce healthcare costs and improve patients’ lives. We are also one of the two major suppliers of life saving hemodialysis concentrate products to kidney dialysis clinics in the United States. The Company has two novel, FDA approved therapies, Triferic and Triferic AVNU, which are the first two products developed from our FPC platform. The Company is target marketing both products to kidney dialysis centers for their patients receiving dialysis and working to find a commercial partner to expand our commercial efforts within the United States. In 2021, Rockwell has been working to advance our FPC platform strategy outside of dialysis by starting a Phase II trial for the treatment of iron deficiency anemia in patients, who are receiving long-term and or chronic intravenous medications for various therapeutic needs in the home infusion setting. In the Company's R&D pipeline, we are also exploring FPC’s impact in the treatment of hospitalized patients with acute heart failure, with the potential to begin another Phase II trial in these patients in 2022. Rockwell Medical is the second largest supplier of hemodialysis concentrates in the United States generating approximately $60 million in annual revenue. The Company's reputation for excellent service, quality, and reliability is based on over 25 years of service to kidney dialysis centers. The Company's approximately 300 dedicated employees, as well as a management team with experience in manufacturing, logistics, pharmaceutical development and commercialization provides Rockwell with a solid foundation upon which to grow.

Liquidity and Capital Resources

Liquidity and Capital Resources	9 Months Ended
	Sep. 30, 2021
Liquidity and Capital Resources [Abstract]
Liquidity and Capital Resources	Liquidity and Capital Resources Since inception, Rockwell has incurred significant net losses and has funded its operations primarily through revenue from commercial products, proceeds from the issuance of debt and equity securities and payments from partnerships. At September 30, 2021, Rockwell had an accumulated deficit of approximately $361.1 million and stockholders' equity of $11.1 million. As of September 30, 2021, Rockwell had approximately $33.2 million of cash, cash equivalents and investments available-for-sale, and working capital of $24.3 million. Net cash used in operating activities for the nine months ended September 30, 2021 was approximately $24.5 million. Based on the currently available working capital, the adjustments made to sales and marketing efforts for Triferic and Triferic AVNU and the implementation of key efficiency initiatives within our concentrates business, management believes the Company currently has sufficient funds to meet its operating requirements for at least the next twelve months from the date of the filing of this report. The Company expects it will require additional capital to sustain its operations and make the investments it needs to execute its strategic plan developing FPC for iron deficiency anemia in patients undergoing home infusion and for progressing our pipeline development program of new indications for its FPC platform. If the Company is unable to generate sufficient revenue from sales of its commercial products and from partnerships, the Company will need to obtain additional equity or debt financing. Currently, because the Company's public float is less than $75 million, we are subject to the baby shelf limitations under our current registration statement on Form S-3, which limit the amount we may offer under our Form S-3. This could limit our ability to raise capital under this registration statement. Additionally, the Company has received a delisting notification letter from the Nasdaq Stock Market ("Nasdaq") regarding compliance with minimum bid requirements. The notification letter states that the Company has 180 calendar days, or until December 8, 2021, to regain compliance with Nasdaq Listing Rule 5450(a)(1). To regain compliance, the closing bid price of the Company’s common stock must be at least $1.00 per share for a minimum of 10 consecutive business days at any time prior to December 8, 2021. In the event that the Company does not regain compliance by December 8, 2021, the Company may be eligible for additional time to reach compliance with the minimum bid price requirement. The Company is working on a plan to meet the minimum compliance requirements set forth by Nasdaq. Based on the above, if the Company attempts to obtain additional debt or equity financing, the Company cannot assume that such financing will be available on favorable terms, if at all. In addition, the Company is subject to certain covenants and cure provisions under its Loan Agreement with Innovatus. As of the date of this report, the Company is in compliance with all covenants. (See Note 15 for further detail). The COVID-19 pandemic and resulting domestic and global disruptions in the supply chain and labor market, among other areas, have adversely affected Rockwell's business and operations, including, but not limited to, our sales and marketing efforts, research and development activities, our plant and transportation operations and the operations of third parties upon whom the Company relies. Quarantines, shelter-in-place, executive and similar government orders and the recent surge in infections domestically may continue to negatively impact Rockwell's business, including with regard to the Company’s manufacturing and transportation and remaining sales and marketing activities. The Company's international business development activities may also continue to be negatively impacted by COVID-19, especially with the recent surge in infections internationally, ongoing international travel restrictions and quarantines or shelter-in-place orders. The COVID-19 pandemic, the domestic and international surge in infections and resulting global disruptions have caused significant volatility in financial and credit markets. Rockwell has utilized a range of financing methods to fund its operations in the past; however, current conditions in the financial and credit markets may limit the availability of funding, refinancing or increase the cost of funding. Due to the continued evolving nature of the global situation, it is not possible to predict the extent to which these conditions could adversely affect the Company's liquidity and capital resources in the future.

Basis of Presentation, Summary

Basis of Presentation, Summary of Significant Accounting Policies and Recent Accounting Pronouncements	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Basis of Presentation, Summary of Significant Accounting Policies and Recent Accounting Pronouncements	Basis of Presentation, Summary of Significant Accounting Policies and Recent Accounting Pronouncements The accompanying condensed consolidated financial statements have been prepared in accordance with the accounting principles generally accepted in the United States of America (“U.S. GAAP”) for interim financial information and pursuant to the instructions to Form 10-Q and Rule 10-01 of Regulation S-X of the U. S. Securities and Exchange Commission (“SEC”) and on the same basis as the Company prepares its annual audited consolidated financial statements. The condensed consolidated balance sheet at September 30, 2021, condensed consolidated statements of operations for the three and nine months ended September 30, 2021 and 2020, condensed consolidated statements of comprehensive loss for the three and nine months ended September 30, 2021 and 2020, condensed consolidated statement of changes in stockholders' equity for the three and nine months ended September 30, 2021 and 2020, and condensed consolidated statements of cash flows for the nine months ended September 30, 2021 and 2020 are unaudited, but include all adjustments, consisting of normal recurring adjustments, that the Company considers necessary for a fair presentation of the financial position, operating results and cash flows for the periods presented. The results for the three and nine months ended September 30, 2021 are not necessarily indicative of results to be expected for the year ending December 31, 2021 or for any future interim period. The condensed consolidated balance sheet at December 31, 2020 has been derived from audited financial statements, however, it does not include all of the information and notes required by U.S. GAAP for complete financial statements. The accompanying condensed consolidated financial statements should be read in conjunction with the audited financial statements for the year ended December 31, 2020 and notes thereto included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2020 as filed with the SEC on March 31, 2021. The Company’s consolidated subsidiaries consisted of its wholly-owned subsidiaries, Rockwell Transportation, Inc. and Rockwell Medical India Private Limited. The accompanying condensed consolidated interim financial statements include the accounts of the Company and its subsidiaries. All material intercompany balances and transactions have been eliminated in consolidation. Use of Estimates The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that may affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of expenses during the reporting period. Actual results could differ from those estimates. Leases The Company accounts for its leases under Accounting Standards Codification (“ASC”) 842, Leases . Under this guidance, arrangements meeting the definition of a lease are classified as operating or financing leases and are recorded on the consolidated balance sheet as both a right-of-use asset and lease liability, calculated by discounting fixed lease payments over the lease term at the rate implicit in the lease or the Company’s incremental borrowing rate. Lease liabilities are increased by interest and reduced by payments each period, and the right-of-use asset is amortized over the lease term. For operating leases, interest on the lease liability and the amortization of the right-of-use asset result in straight-line rent expense over the lease term. Variable lease expenses, if any, are recorded when incurred. In calculating the right-of-use asset and lease liability, the Company elects to combine lease and non-lease components. The Company excludes short-term leases having initial terms of 12 months or less from the new guidance as an accounting policy election and recognizes rent expense on a straight-line basis over the lease term. Loss Per Share ASC 260, Earnings Per Share , requires dual presentation of basic and diluted earnings per share (“EPS”), with a reconciliation of the numerator and denominator of the basic EPS computation to the numerator and denominator of the diluted EPS computation. Basic EPS excludes dilution. Diluted EPS reflects the potential dilution that could occur if securities or other contracts to issue common stock were exercised or converted into common stock or resulted in the issuance of common stock that are then sharing in the earnings of the entity. Basic net loss per share of common stock excludes dilution and is computed by dividing the net loss by the weighted average number of shares outstanding during the period. Diluted net loss per share of common stock reflects the potential dilution that could occur if securities or other contracts to issue common stock were exercised or converted into common stock or resulted in the issuance of common stock that then shared in the earnings of the entity unless inclusion of such shares would be anti-dilutive. The Company has only incurred losses, therefore, basic and diluted net loss per share is the same. Securities that could potentially dilute net income per share in the future that were not included in the computation of diluted loss per share were as follows: As of September 30, 2021 2020 Options to purchase common stock 5,871,620 6,682,192 Unvested restricted stock awards 78,300 146,800 Unvested restricted stock units 342,271 245,405 Warrants to purchase common stock 26,426,863 26,426,863 Total 32,719,054 33,501,260 Adoption of Recent Accounting Pronouncements The Company continually assesses new accounting pronouncements to determine their applicability. When it is determined that a new accounting pronouncement affects the Company’s financial reporting, the Company undertakes a review to determine the consequences of the change to its consolidated financial statements and assures that there are sufficient controls in place to ascertain that the Company’s consolidated financial statements properly reflect the change. In April 2021, the Financial Accounting Standards Board ("FASB") recently issued Accounting Standards Update ("ASU") 2021-04 to codify the final consensus reached by the Emerging Issues Task Force (EITF) on how an issuer should account for modifications made to equity-classified written call options (hereafter referred to as a warrant to purchase the issuer’s common stock). The guidance in the ASU requires the issuer to treat a modification of an equity-classified warrant that does not cause the warrant to become liability-classified as an exchange of the original warrant for a new warrant. This guidance applies whether the modification is structured as an amendment to the terms and conditions of the warrant or as termination of the original warrant and issuance of a new warrant. The Company is evaluating the impact of this guidance on its condensed consolidated financial statements.

Revenue Recognition

Revenue Recognition	9 Months Ended
	Sep. 30, 2021
Revenue from Contract with Customer [Abstract]
Revenue Recognition	Revenue Recognition The Company recognizes revenue under ASC 606, Revenue from Contracts with Customers. The core principle of the new revenue standard is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. The following five steps are applied to achieve that core principle: • Step 1: Identify the contract with the customer • Step 2: Identify the performance obligations in the contract • Step 3: Determine the transaction price • Step 4: Allocate the transaction price to the performance obligations in the contract • Step 5: Recognize revenue when the company satisfies a performance obligation Taxes assessed by a governmental authority that are both imposed on and concurrent with a specific revenue-producing transaction, that are collected by us from a customer, are excluded from revenue. Shipping and handling costs associated with outbound freight related to contracts with customers are accounted for as a fulfillment cost and are included in cost of sales when control of the goods transfers to the customer. Nature of goods and services The following is a description of principal activities from which the Company generates its revenue. Product sales – The Company accounts for individual products and services separately if they are distinct (i.e., if a product or service is separately identifiable from other items and if a customer can benefit from it on its own or with other resources that are readily available to the customer). The consideration, including any discounts, is allocated between separate products and services based on their stand-alone selling prices. The stand-alone selling prices are determined based on the cost plus margin approach. Drug and dialysis concentrate products are sold directly to dialysis clinics and to wholesale distributors in both domestic and international markets. Distribution and license agreements for which upfront fees are received are evaluated upon execution or modification of the agreement to determine if the agreement creates a separate performance obligation from the underlying product sales. For all existing distribution and license agreements, the distribution and license agreement is not a distinct performance obligation from the product sales. In instances where regulatory approval of the product has not been established and the Company does not have sufficient experience with the foreign regulatory body to conclude that regulatory approval is probable, the revenue for the performance obligation is recognized over the term of the license agreement (over time recognition). Conversely, when regulatory approval already exists or is probable, revenue is recognized at the point in time that control of the product transfers to the customer. The Company received upfront fees under five distribution and license agreements that have been deferred as a contract liability. The amounts received from Wanbang Biopharmaceuticals Co., Ltd. (“Wanbang”), Sun Pharmaceutical Industries Ltd. ("Sun Pharma"), Jeil Pharmaceutical Co., Ltd. ("Jeil Pharma") and Drogsan Pharmaceuticals ("Drogsan Pharma") are recognized as revenue over the estimated term of the applicable distribution and license agreement as regulatory approval was not received and the Company did not have sufficient experience in China, India and South Korea, respectively, to determine that regulatory approval was probable as of the execution of the agreement. The amounts received from Baxter Healthcare Corporation (“Baxter”) are recognized as revenue at the point in time that the estimated product sales under the agreement occur. For the business under the Company’s Distribution Agreement with Baxter (the “Baxter Agreement”), and for the majority of the Company’s international customers, the Company recognizes revenue at the shipping point, which is generally the Company’s plant or warehouse. For other business, the Company recognizes revenue based on when the customer takes control or receipt of the product. The amount of revenue recognized is based on the purchase order less returns and adjusted for any rebates, discounts, chargebacks or other amounts paid to customers. There were no such adjustments for the periods reported. Customers typically pay for the product based on customary business practices with payment terms averaging 30 days, while distributor payment terms average 45 days. Disaggregation of revenue Revenue is disaggregated by primary geographical market, major product line, and timing of revenue recognition. In thousands of U.S. dollars ($) Three Months Ended September 30, 2021 Nine Months Ended September 30, 2021 Products By Geographic Area Total U.S. Rest of World Total U.S. Rest of World Drug Revenues Product Sales – Point-in-time $ 217 $ 217 $ — $ 656 $ 656 $ — License Fee – Over time 62 — 62 179 — 179 Total Drug Products 279 217 62 835 656 179 Concentrate Products Product Sales – Point-in-time 15,224 13,541 1,683 44,308 39,768 4,540 License Fee – Over time 485 485 — 1,456 1,456 — Total Concentrate Products 15,709 14,026 1,683 45,764 41,224 4,540 Net Revenue $ 15,988 $ 14,243 $ 1,745 $ 46,599 $ 41,880 $ 4,719 In thousands of U.S. dollars ($) Three Months Ended September 30, 2020 Nine Months Ended September 30, 2020 Products By Geographic Area Total U.S. Rest of World Total U.S. Rest of World Drug Revenues Product Sales – Point-in-time $ 228 $ 228 $ — $ 609 $ 609 $ — License Fee – Over time 56 — 56 167 — 167 Total Drug Products 284 228 56 776 609 167 Concentrate Products Product Sales – Point-in-time 14,506 13,470 1,036 44,786 40,295 4,491 License Fee – Over time 490 490 — 1,471 1,471 — Total Concentrate Products 14,996 13,960 1,036 46,257 41,766 4,491 Net Revenue $ 15,280 $ 14,188 $ 1,092 $ 47,033 $ 42,375 $ 4,658 Contract balances The following table provides information about receivables, contract assets, and contract liabilities from contracts with customers. In thousands of U.S. dollars ($) September 30, 2021 December 31, 2020 Receivables, which are included in "Trade and other receivables" $ 6,036 $ 4,171 Contract liabilities $ 8,705 $ 10,190 There were no material losses recognized related to any receivables arising from the Company’s contracts with customers for the three and nine months ended September 30, 2021 and 2020. For the three and nine months ended September 30, 2021 and September 30, 2020, the Company did not recognize any material bad-debt expense. There were no material contract assets recorded on the condensed consolidated balance sheet as of September 30, 2021 and December 31, 2020. The Company does not generally accept returns of its concentrate products and no material reserve for returns of concentrate products was established as of September 30, 2021 or December 31, 2020. The contract liabilities primarily relate to upfront payments and consideration received from customers that are received in advance of the customer assuming control of the related products Transaction price allocated to remaining performance obligations For the three and nine months ended September 30, 2021, revenue recognized from performance obligations related to prior periods was not material.

Investments - Available-for-Sal

Investments - Available-for-Sale	9 Months Ended
	Sep. 30, 2021
Investments, Debt and Equity Securities [Abstract]
Investments - Available-for-Sale	Investments - Available-for-Sale Investments available-for-sale consisted of the following as of September 30, 2021 and December 31, 2020 (table in thousands): September 30, 2021 Amortized Cost Unrealized Gain Unrealized Loss Accrued Interest Income Fair Value Available-for-Sale Securities Bonds $ 9,805 $ 1 $ — $ 7 $ 9,813 December 31, 2020 Amortized Cost Unrealized Gain Unrealized Loss Accrued Interest Fair Value Available-for-Sale Securities Bonds $ 9,987 $ 3 $ — $ 7 $ 9,997 The fair value of investments available-for-sale are determined using quoted market prices from daily exchange-traded markets based on the closing price as of the balance sheet date and are classified as a Level 1 measurement under ASC 820 Fair Value Measurements. As of September 30, 2021 and December 31, 2020, the amortized cost and estimated fair value of our available-for-sale securities were due within one year.

Inventory

Inventory	9 Months Ended
	Sep. 30, 2021
Inventory Disclosure [Abstract]
Inventory	Inventory Components of inventory, net of reserves, as of September 30, 2021 and December 31, 2020 are as follows (table in thousands): September 30, December 31, Raw Materials $ 3,507 $ 3,112 Work in Process 266 172 Finished Goods 1,781 1,805 Total $ 5,554 $ 5,089 As of September 30, 2021, the Company classified $1.5 million of inventory as non-current, all of which was related to Triferic or the active pharmaceutical ingredient and raw materials for Triferic. As of September 30, 2021, the total Triferic inventory net of reserve was $1.6 million. The $1.6 million net value of Triferic inventory consisted of $0.4 million of Triferic (dialysate) finished goods with expiration dates ranging from September 2021 to December 2023, $0.4 million of Triferic API with estimated remaining shelf life extending beyond 2022, and $0.9 million of raw materials for Triferic with estimated remaining shelf life extending beyond 2025.

Property and Equipment

Property and Equipment	9 Months Ended
	Sep. 30, 2021
Property, Plant and Equipment [Abstract]
Property and Equipment	Property and Equipment As of September 30, 2021 and December 31, 2020, the Company’s property and equipment consisted of the following (table in thousands): September 30, December 31, Leasehold Improvements $ 1,196 $ 1,196 Machinery and Equipment 5,794 5,475 Information Technology & Office Equipment 1,846 1,831 Laboratory Equipment 676 676 9,512 9,178 Accumulated Depreciation (7,005) (6,536) Property and Equipment, net $ 2,507 $ 2,642

Accrued Liabilities

Accrued Liabilities	9 Months Ended
	Sep. 30, 2021
Payables and Accruals [Abstract]
Accrued Liabilities	Accrued Liabilities Accrued liabilities as of September 30, 2021 and December 31, 2020 consisted of the following (table in thousands): September 30, December 31, Accrued Research & Development Expense $ 181 $ 232 Accrued Compensation and Benefits 2,193 2,500 Accrued Unvouchered Receipts 622 755 Accrued Workers Compensation 434 395 Other Accrued Liabilities 941 1,131 Total Accrued Liabilities $ 4,371 $ 5,013

Deferred Revenue

Deferred Revenue	9 Months Ended
	Sep. 30, 2021
Revenue from Contract with Customer [Abstract]
Deferred Revenue	Deferred Revenue In October 2014, the Company entered into the Baxter Agreement with Baxter and received an upfront fee of $20 million. The upfront fee was recorded as deferred revenue and is being recognized based on the proportion of product shipments to Baxter in each period, compared with total expected sales volume over the term of the Baxter Agreement, which expires in October 2024 and is subject to extension. The Company recognized revenue of approximately $0.5 million and $1.5 million for each of the three and nine months ended September 30, 2021 and 2020. Deferred revenue related to the Baxter Agreement totaled $5.7 million as of September 30, 2021 and $7.2 million as of December 31, 2020. If a “Refund Trigger Event” occurs under the Baxter Agreement prior to December 31, 2021, Rockwell would be obligated to repay 25% of the upfront fee. In 2016, the Company entered into a distribution and license agreement with Wanbang (the "Wanbang Agreement") and received an upfront fee of $4.0 million. The upfront fee was recorded as deferred revenue and is being recognized as revenue based on the agreement term. The Company recognized approximately $53,000 and $0.2 million revenue for each of the three and nine months ended September 30, 2021 and 2020. Deferred revenue related to the Wanbang Agreement totaled $2.6 million as of September 30, 2021 and $2.7 million as of December 31, 2020. In January 2020, the Company entered into license and supply agreements with Sun Pharma (the "Sun Pharma Agreements"), for the rights to commercialize Triferic (dialysate) (ferric pyrophosphate citrate) in India. Under the terms of the Sun Pharma Agreements, Sun Pharma will be the exclusive development and commercialization partner for Triferic (dialysate) in India, and the Company will supply the product to Sun Pharma. In consideration for the license, the Company received an upfront fee of $0.1 million, and will be eligible for milestone payments and royalties on net sales. A Joint Alliance Committee, comprised of members from the Company and Sun Pharma, will guide the development and execution for Triferic (dialysate) in India. Sun Pharma will be responsible for all clinical and regulatory approval, as well as commercialization activities. The upfront fee was recorded as deferred revenue and is being recognized as revenue based on the agreement term. The Company recognized revenue of approximately $2,500 and $7,500 for each of the three and nine months ended September 30, 2021 and 2020. Deferred revenue related to the Sun Pharma Agreement totaled $82,500 and $90,000 as of September 30, 2021 and December 31, 2020, respectively. In September 2020, the Company entered into a license and supply agreements with Jeil Pharma (the "Jeil Pharma Agreements"), for the rights to commercialize Triferic (dialysate) (ferric pyrophosphate citrate) in South Korea. Under the terms of the Jeil Pharma Agreements, Jeil Pharma will be the exclusive development and commercialization partner for Triferic (dialysate) in South Korea, and the Company will supply the product to Jeil Pharma. In consideration for the license, the Company received an upfront fee of $0.2 million, and will be eligible for milestone payments and royalties on net sales. A Joint Alliance Committee, comprised of members from the Company and Jeil Pharma, will guide the development and execution for Triferic (dialysate) in South Korea. Jeil Pharma will be responsible for all clinical and regulatory approval, as well as commercialization activities. The upfront fee was recorded as deferred revenue and is being recognized as revenue based on the agreement term. The Company recognized revenue of $2,500 and nil for the three months ended September 30, 2021 and 2020, respectively, and $7,500 and nil for the nine months ended September 30, 2021 and 2020, respectively. Deferred revenue related to the Jeil Pharma Agreement totaled approximately $0.2 million as of September 30, 2021 and December 31, 2020. In June 2021, the Company entered into license and supply agreements with Drogsan Pharma (the "Drogsan Agreements"), for the rights to commercialize Triferic (dialysate) and Triferic AVNU in Turkey. Under the terms of the Drogsan Agreements, Drogsan Pharma will be the exclusive commercialization partner for Triferic (dialysate) and Triferic AVNU in Turkey. In consideration for the license, the Company received an upfront fee of $0.15 million, and will be eligible for milestone payment and royalties on net sales. A Joint Alliance Committee, comprised of members from the Company and Drogsan Pharma, will guide the execution for Triferic (dialysate) and Triferic AVNU in Turkey. Drogsan Pharma will be responsible for all regulatory approval and commercialization activities, and the Company will supply the product to Drogsan Pharma for Turkey. The upfront fee will be recorded as deferred revenue and will be recognized as revenue based on the agreement term. The Company recognized revenue of $3,750 for the three months ended September 30, 2021. Deferred revenue related to the Drogsan Agreements totaled approximately $0.15 million as of September 30, 2021.

Stockholders_ Equity

Stockholders’ Equity	9 Months Ended
	Sep. 30, 2021
Equity [Abstract]
Stockholders' Equity	Stockholders’ Equity Preferred Stock As of September 30, 2021 and December 31, 2020, there were 2,000,000 shares of preferred stock, $0.0001 par value per share, authorized and no shares of preferred stock issued or outstanding. Common Stock As of September 30, 2021 and December 31, 2020, there were 170,000,000 shares of common stock, $0.0001 par value per share, authorized and 93,966,381 and 93,573,165 shares issued and outstanding, respectively. Controlled Equity Offering (or "At the Market" Offering) On March 22, 2019, the Company entered into a sales agreement (the “Sales Agreement”) with Cantor Fitzgerald & Co. (the “Agent”), pursuant to which the Company may offer and sell from time to time shares of the Company’s common stock through the Agent. The offering and sale of up to $40.0 million of the shares has been registered under the Securities Act of 1933, as amended (the "Securities Act"), pursuant to the Company’s registration statement on Form S-3 (File No. 333-227363), which was originally filed with the SEC on September 14, 2018 and declared effective by the SEC on October 1, 2018, the base prospectus contained within the registration statement, and a prospectus supplement that was filed with the SEC on March 22, 2019. The registration statement on Form S-3 expired on October 1, 2021 and no further sales may be made under the Sales Agreement. During the three and nine months ended September 30, 2021, the Company has not sold shares of its common stock pursuant to the Sales Agreement. Approximately $32.3 million remained available for sale under this facility as of September 30, 2021.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2021
Share-based Payment Arrangement [Abstract]
Stock-Based Compensation	Stock-Based Compensation The Company recognized total stock-based compensation expense during the three and nine months ended September 30, 2021 and 2020 as follows (table in thousands): Three Months Ended Nine Months Ended 2021 2020 2021 2020 Service-based awards: Restricted stock units $ 81 $ 9 $ 263 $ 243 Stock option awards 315 243 1,050 1,019 396 252 1,313 1,262 Performance-based awards: Restricted stock awards — — (391) — Restricted stock units — (123) — (1,148) Stock option awards (35) 121 (364) (390) (35) (2) (755) (1,538) Total $ 361 $ 250 $ 558 $ (276) Restricted Stock A summary of the Company’s restricted stock awards during the nine months ended September 30, 2021 is as follows: Number of Shares Weighted Average Unvested at January 1, 2021 146,800 $ 5.70 Forfeited (68,500) $ 5.70 Unvested at September 30, 2021 78,300 $ 5.70 A summary of the Company’s restricted stock awards during the nine months ended September 30, 2020 is as follows: Number of Shares Weighted Average Unvested at January 1, 2020 146,800 $ 5.70 Unvested at September 30, 2020 146,800 $ 5.70 The fair value of restricted stock awards are measured based on their fair value on the date of grant and amortized over the vesting period of 20 months. As of September 30, 2021, unvested restricted stock awards of 78,300 were related to performance-based awards. The forfeited performance-based restricted stock awards of 68,500 was due to the termination of the Company's former Chief Science Officer on January 19, 2021. These forfeited awards reduced stock-based compensation expense by $0.4 million. Service-Based Restricted Stock Units A summary of the Company’s service-based restricted stock units during the nine months ended September 30, 2021 is as follows: Number of Shares Weighted Average Unvested at January 1, 2021 265,494 $ 2.60 Granted 310,050 0.90 Vested (221,474) 2.38 Forfeited (11,799) 4.81 Unvested at September 30, 2021 342,271 $ 1.17 A summary of the Company’s service-based restricted stock units during the nine months ended September 30, 2020 is as follows: Number of Shares Weighted Average Unvested at January 1, 2020 463,786 $ 4.26 Granted 188,904 2.09 Vested (247,561) 4.30 Forfeited (159,724) 4.26 Unvested at September 30, 2020 245,405 $ 2.72 The fair value of service based restricted stock units are measured based on their fair value on the date of grant and amortized over the vesting period. The vesting periods range from 1 to 3 years. Stock-based compensation expense of $0.1 million and $0.3 million was recognized for the three and nine months ended September 30, 2021, respectively. Stock-based compensation expense of nil and $0.2 million was recognized for the three and nine months ended September 30, 2020, respectively. As of September 30, 2021, the unrecognized stock-based compensation expense was $0.2 million, which is expected to be recognized over an estimated weighted average remaining term of less than 1 year. Performance-Based Restricted Stock Units As of September 30, 2021, there were no outstanding performance-based restricted stock units. A summary of the Company’s performance-based restricted stock units during the nine months ended September 30, 2020 is as follows: Number of Shares Weighted Average Unvested at January 1, 2020 988,958 $ 4.48 Forfeited (988,958) 4.48 Unvested at Unvested at September 30, 2020 — $ — Service-Based Stock Options The fair value of the service-based stock options granted for the nine months ended September 30, 2021 were based on the following assumptions: September 30, Exercise price $0.61 - $1.73 Expected stock price volatility 75.8% - 77.7% Risk-free interest rate 0.47% - 1.06% Term (years) 5.5 - 6 A summary of the Company’s service-based stock option activity for the nine months ended September 30, 2021 is as follows: Shares Weighted Weighted Aggregate Outstanding at January 1, 2021 5,717,956 $ 4.55 6.6 $ — Granted 1,872,162 0.89 6.0 — Forfeited (385,278) 2.30 — — Expired (1,333,220) 7.16 — — Outstanding at September 30, 2021 5,871,620 $ 2.95 7.7 $ — Exercisable at September 30, 2021 2,539,438 $ 4.96 5.8 $ — A summary of the Company’s service-based stock option activity for the nine months ended September 30, 2020 is as follows: Shares Weighted Weighted Aggregate Outstanding at January 1, 2020 8,210,024 $ 7.06 5.1 $ 107,000 Granted 2,252,344 1.95 5.9 — Forfeited (440,026) 3.96 — — Expired (4,090,150) 8.24 — — Outstanding at September 30, 2020 5,932,192 $ 4.54 6.7 $ — Exercisable at September 30, 2020 2,889,218 $ 6.95 3.8 $ — The aggregate intrinsic value in the table above is calculated as the difference between the closing price of the Company's common stock and the exercise price of the stock options that had strike prices below the closing price. During the nine months ended September 30, 2021, the Company granted stock options to purchase up to 1,872,162 shares of common stock to certain employees. During the nine months ended September 30, 2021, 385,278 shares were forfeited and 1,333,220 shares expired. Forfeitures are recorded in the period of occurrence; compensation expense is adjusted accordingly. Stock-based compensation expense recognized for service-based stock options was $0.3 million and $1.0 million for the three and nine months ended September 30, 2021, respectively. Stock-based compensation expense recognized for service-based stock options was $0.2 million and $1.0 million for the three and nine months ended September 30, 2020, respectively. As of September 30, 2021, total stock-based compensation expense related to unvested options not yet recognized totaled approximately $1.7 million, which is expected to be recognized over an estimated weighted average remaining term of 3.0 years. Performance-Based Stock Options A summary of the performance-based stock options for the nine months ended September 30, 2021 is as follows: Number of Shares Weighted Average Outstanding at January 1, 2021 750,000 $ 2.20 Expired (750,000) 2.20 Outstanding at September 30, 2021 — $ — Exercisable at September 30, 2021 — $ — A summary of the performance-based stock options for the nine months ended September 30, 2020 is as follows: Number of Shares Weighted Average Outstanding at January 1, 2020 388,125 $ 4.70 Granted 750,000 $ 2.20 Forfeited (388,125) $ 4.70 Outstanding at September 30, 2020 750,000 $ 2.20 Exercisable at September 30, 2020 — $ — Stock-based compensation expense recognized for performance-based stock options was nil and $(0.4) million for the three and nine months ended September 30, 2021, respectively. Stock-based compensation expense recognized for performance-based stock options was $0.1 million and $(0.4) million for the three and nine months ended September 30, 2020, respectively. The increase in expired performance-based stock options and reduction in stock-based compensation expense was due to the performance criteria of certain performance-based options granted to officers of the Company becoming non-probable as of September 30, 2021. As of September 30, 2021, there was no unrecognized stock-based compensation expense related to unvested performance-based stock options.

Licensing Agreements

Licensing Agreements	9 Months Ended
	Sep. 30, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Licensing Agreements	Licensing Agreements Product License Agreements The Company is a party to a Licensing Agreement with Charak, LLC ("Charak") dated January 7, 2002 (the "2002 Agreement") that grants the Company exclusive worldwide rights to certain patents and information related to our Triferic® product. On October 7, 2018, the Company entered into a Master Services and IP Agreement (the “Charak MSA”) with Charak and Dr. Ajay Gupta, a former Officer of the Company. Pursuant to the MSA, the parties entered into three additional agreements described below related to the license of certain soluble ferric pyrophosphate (“SFP”) intellectual property owned by Charak. The Charak MSA provided for a payment of $1.0 million to Dr. Gupta, payable in four quarterly installments of $250,000 each on October 15, 2018, January 15, 2019, April 15, 2019 and July 15, 2019, and reimbursement for certain legal fees incurred in connection with the Charak MSA. The Company paid all four of the quarterly installments totaling $1.0 million and accrued $0.1 million for the reimbursement of certain legal expenses during the year ended December 31, 2019. As of December 31, 2020, the Company had fulfilled its reimbursement obligation of certain legal expenses. As of September 30, 2021, the Company accrued $0.2 million relating to certain IP reimbursement expenses and certain sublicense royalty fees within accrued liabilities on the condensed consolidated balance sheet. Pursuant to the Charak MSA, the aforementioned parties entered into an Amendment, dated as of October 7, 2018 (the “Charak Amendment”), to the 2002 Agreement, under which Charak granted the Company an exclusive, worldwide, non-transferable license to commercialize SFP for the treatment of patients with renal failure. The Charak Amendment amends the royalty payments due to Charak under the 2002 Agreement such that the Company is liable to pay Charak royalties on net sales by the Company of products developed under the license, which includes the Company’s Triferic® product, at a specified rate until December 31, 2021 and thereafter at a reduced rate from January 1, 2022 until February 1, 2034. Additionally, the Company shall pay Charak a percentage of any sublicense income during the term of the agreement, which amount shall not be less than a minimum specified percentage of net sales of the licensed products by the sub-licensee in jurisdictions where there exists a valid claim, on a country-by-country basis, and be no less than a lower rate of the net sales of the licensed products by the sub-licensee in jurisdictions where there exists no valid claim, on a country-by-country basis. Also pursuant to the Charak MSA, the Company and Charak entered into a Commercialization and Technology License Agreement I.V. Triferic® (now Triferic AVNU), dated as of October 7, 2018 (the “IV Agreement”), under which Charak granted the Company an exclusive, sub-licensable, royalty-bearing license to SFP for the purpose of commercializing certain intravenous-delivered products incorporating SFP for the treatment of iron disorders worldwide for a term that expires on the later of February 1, 2034 or upon the expiration or termination of a valid claim of a licensed patent. The Company is liable to pay Charak royalties on net sales by the Company of products developed under the license at a specified rate until December 31, 2021. From January 1, 2022 until February 1, 2034, the Company is liable to pay Charak a base royalty at a reduced rate on net sales and an additional royalty on net sales while there exists a valid claim of a licensed patent, on a country-by-country basis. The Company shall also pay to Charak a percentage of any sublicense income received during the term of the IV Agreement, which amount shall not be less than a minimum specified percentage of net sales of the licensed products by the sub-licensee in jurisdictions where there exists a valid claim, on a country-by-country basis, and not be less than a lower rate of the net sales of the licensed products by the sub-licensee in jurisdictions where there exists no valid claim, on a country-by-country basis. Also pursuant to the Charak MSA, the Company and Charak entered into a Technology License Agreement TPN Triferic®, dated as of October 7, 2018 (the “TPN Agreement”), pursuant to which Charak granted the Company an exclusive, sublicensable, royalty-bearing license to SFP for the purpose of commercializing worldwide certain parenteral nutritional ("TPN”) products incorporating SFP. The license grant under the TPN Agreement continues for a term that expires on the later of February 1, 2034 or upon the expiration or termination of a valid claim of a licensed patent. During the term of the TPN Agreement, the Company is liable to pay Charak a base royalty on net sales and an additional royalty on net sales while there exists a valid claim of a licensed patent, on a country-by-country basis. The Company shall also pay to Charak a percentage of any sublicense income received during the term of the TPN Agreement, which amount shall not be less than a minimum royalty on net sales of the licensed products by the sub-licensee in jurisdictions where there exists a valid claim, on a country-by-country basis, and not be less than a lower rate of the net sales of the licensed products by the sub-licensee in jurisdictions where there exists no valid claim, on a country-by-country basis.

Leases

Leases	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
Leases	Leases The Company leases its production facilities and administrative offices as well as certain equipment used in our operations including leases on transportation equipment used in the delivery of its products. The lease terms range from monthly to five years. The Company occupies a 51,000 square foot facility and a 17,500 square foot facility in Wixom, Michigan under a lease expiring in August 2024. The Company also occupies two other manufacturing facilities, a 51,000 square foot facility in Grapevine, Texas under a lease expiring in December 2025, and a 57,000 square foot facility in Greer, South Carolina under a lease expiring February 2023. In addition, the Company occupies 4,100 square feet of office space in Hackensack, New Jersey under a lease expiring on July 1, 2024. This lease is currently being offered for sublease. At September 30, 2021, the Company had operating and finance lease liabilities of $7.1 million and right-of-use assets of $6.9 million, which are included in the consolidated balance sheet. At December 31, 2020, the Company had operating lease liabilities of $3.0 million and right-of-use assets of $2.9 million, which are included in the consolidated balance sheet. The following summarizes quantitative information about the Company’s operating leases (table in thousands): Three Months Ended September 30, 2021 Three Months Ended September 30, 2020 Nine Months Ended September 30, 2021 Nine Months Ended September 30, 2020 Operating leases Operating lease cost $ 457 $ 382 $ 1,309 $ 1,228 Variable lease cost 94 90 286 403 Operating lease expense 551 472 1,595 1,631 Finance leases Amortization of right-of-use assets 73 — 184 — Interest on lease obligations 22 — 55 — Finance lease expense 95 — 239 — Short-term lease rent expense 4 4 12 12 Total rent expense $ 650 $ 476 $ 1,846 $ 1,643 Other information Operating cash flows from operating leases $ 444 $ 393 $ 1,298 $ 1,248 Operating cash flows from finance leases $ 22 $ — $ 56 $ — Financing cash flows from finance leases $ 59 $ — $ 152 $ — Right of use assets exchanged for operating lease liabilities $ 718 $ — $ 4,089 $ — Right of use assets exchanged for finance lease liabilities $ 588 $ — $ 1,365 $ — Weighted-average remaining lease term – operating leases 3.7 2.3 3.7 2.3 Weighted-average remaining lease term – finance leases 5.5 0.0 5.5 0.0 Weighted-average discount rate – operating leases 6.3 % 6.8 % 6.3 % 6.8 % Weighted-average discount rate – finance leases 5.9 % — % 5.9 % — % Future minimum rental payments under operating lease agreements are as follows (in thousands): Operating Finance Year ending December 31, 2021 (remaining) $ 470 $ 103 Year ending December 31, 2022 1,746 418 Year ending December 31, 2023 1,429 424 Year ending December 31, 2024 1,076 424 Year ending December 31, 2025 616 426 Remaining future payments 345 526 Total $ 5,682 $ 2,321 Less present value discount (607) (338) Operating and finance lease liabilities $ 5,075 $ 1,983
Leases	Leases The Company leases its production facilities and administrative offices as well as certain equipment used in our operations including leases on transportation equipment used in the delivery of its products. The lease terms range from monthly to five years. The Company occupies a 51,000 square foot facility and a 17,500 square foot facility in Wixom, Michigan under a lease expiring in August 2024. The Company also occupies two other manufacturing facilities, a 51,000 square foot facility in Grapevine, Texas under a lease expiring in December 2025, and a 57,000 square foot facility in Greer, South Carolina under a lease expiring February 2023. In addition, the Company occupies 4,100 square feet of office space in Hackensack, New Jersey under a lease expiring on July 1, 2024. This lease is currently being offered for sublease. At September 30, 2021, the Company had operating and finance lease liabilities of $7.1 million and right-of-use assets of $6.9 million, which are included in the consolidated balance sheet. At December 31, 2020, the Company had operating lease liabilities of $3.0 million and right-of-use assets of $2.9 million, which are included in the consolidated balance sheet. The following summarizes quantitative information about the Company’s operating leases (table in thousands): Three Months Ended September 30, 2021 Three Months Ended September 30, 2020 Nine Months Ended September 30, 2021 Nine Months Ended September 30, 2020 Operating leases Operating lease cost $ 457 $ 382 $ 1,309 $ 1,228 Variable lease cost 94 90 286 403 Operating lease expense 551 472 1,595 1,631 Finance leases Amortization of right-of-use assets 73 — 184 — Interest on lease obligations 22 — 55 — Finance lease expense 95 — 239 — Short-term lease rent expense 4 4 12 12 Total rent expense $ 650 $ 476 $ 1,846 $ 1,643 Other information Operating cash flows from operating leases $ 444 $ 393 $ 1,298 $ 1,248 Operating cash flows from finance leases $ 22 $ — $ 56 $ — Financing cash flows from finance leases $ 59 $ — $ 152 $ — Right of use assets exchanged for operating lease liabilities $ 718 $ — $ 4,089 $ — Right of use assets exchanged for finance lease liabilities $ 588 $ — $ 1,365 $ — Weighted-average remaining lease term – operating leases 3.7 2.3 3.7 2.3 Weighted-average remaining lease term – finance leases 5.5 0.0 5.5 0.0 Weighted-average discount rate – operating leases 6.3 % 6.8 % 6.3 % 6.8 % Weighted-average discount rate – finance leases 5.9 % — % 5.9 % — % Future minimum rental payments under operating lease agreements are as follows (in thousands): Operating Finance Year ending December 31, 2021 (remaining) $ 470 $ 103 Year ending December 31, 2022 1,746 418 Year ending December 31, 2023 1,429 424 Year ending December 31, 2024 1,076 424 Year ending December 31, 2025 616 426 Remaining future payments 345 526 Total $ 5,682 $ 2,321 Less present value discount (607) (338) Operating and finance lease liabilities $ 5,075 $ 1,983

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2021
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Litigation SEC Investigation As a follow up to certain prior inquiries, the Company received a subpoena from the SEC during the Company’s quarter ended September 30, 2018 requesting, among other things, certain information and documents relating to the status of the Company’s request to the Centers for Medicare & Medicaid Services (the "CMS") for separate reimbursement

Loans and Security Agreement

Loans and Security Agreement	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Loans and Security Agreement	Loan and Security Agreement In March 2020, Rockwell Medical, Inc. and Rockwell Transportation, Inc., as Borrowers, entered into a Loan and Security Agreement (the "Loan Agreement") with Innovatus Life Sciences Lending Fund I, LP ("Innovatus"), as collateral agent and the lenders party thereto, pursuant to which Innovatus, as a lender, agreed to make certain term loans to the Company in the aggregate principal amount of up to $35.0 million (the "Term Loans"). Funding of the first $22.5 million tranche was completed on March 16, 2020. The Company is no longer eligible to draw on a second tranche of $5.0 million, which was tied to the achievement of certain milestones by a specific date. The Company may be eligible to draw on a third tranche of $7.5 million upon the achievement of certain additional milestones, including the achievement of certain Triferic sales thresholds. Net draw down proceeds were $21.2 million with closing costs of $1.3 million. The Company is entitled to make interest-only payments for thirty months, or up to thirty-six months if certain conditions are met. The Term Loans will mature on March 16, 2025, and will bear interest at the greater of (i) Prime Rate (as defined in the Loan Agreement) and (ii) 4.75%, plus 4.00% with an initial interest rate of 8.75% per annum and an effective interest rate of 11.3%. The Company has the option, under certain circumstances, to add 1.00% of such interest rate amount to the then outstanding principal balance in lieu of paying such amount in cash. For each of the three months ended September 30, 2021 and 2020, interest expense amounted to $0.6 million and $0.7 million, respectively. For the nine months ended September 30, 2021 and 2020, interest expense amounted to $1.8 million and $1.3 million, respectively. The Loan Agreement is secured by all assets of the Company and Rockwell Transportation, Inc. Proceeds are being used for working capital purposes. The Loan Agreement contains customary representations and warranties and covenants, subject to customary carve outs, and includes financial covenants related to liquidity and trailing twelve months sales of Triferic, with the latter beginning with the period ending December 31, 2020. The Company cannot assure you that we can maintain compliance with the covenants under our Loan Agreement, which may result in an event of default. The Company's ability to comply with these covenants may be adversely affected by events beyond its control. For example, the Loan Agreement contains certain financial covenants relating to sales and, as a result of the ongoing COVID-19 pandemic and its effect on the Company's sales activities, among other factors, the Company may not be able to satisfy such covenants in the future. If the Company is unable to comply with the covenants under the Loan Agreement, it would pursue all available cure options in order to regain compliance. The Company previously failed to satisfy a revenue covenant for the period ended December 31, 2020 and then subsequently agreed to an appropriate remedy during the applicable cure period. However, the Company may not be able to mutually agree with Innovatus on appropriate remedies to cure a future breach of a covenant, which could give rise to an event of default. If the Company is unable to avoid an event of default, any required repayments could have an adverse effect on its liquidity. As of September 30, 2021, the Company is in compliance with all the reporting and financial covenants. The financial statements for September 30, 2021 have been prepared with the assumption that the Company will be able to agree to an appropriate remedy during the applicable cure period for any future breaches of operating covenants. Based on the foregoing, the Company has classified amounts payable under the Loan Agreement as a current liability. If and when the Company reaches an agreement with Innovatus to avoid an event of default, the amounts payable under the Loan Agreement will be reevaluated for its classification and presentation. In connection with each funding of the Term Loans, the Company is required to issue to Innovatus a warrant (the “Warrants”) to purchase a number of shares of the Company’s common stock equal to 3.5% of the principal amount of the relevant Term Loan funded divided by the exercise price, which will be based on the lower of (i) the volume weighted average closing price of the Company’s stock for the 5-trading day period ending on the last trading day immediately preceding the execution of the Loan Agreement or (ii) the closing price on the last trading day immediately preceding the execution of the Loan Agreement (or for the second and third tranches only at the lower of (i) $1.65 per share or (ii) the volume weighted average closing price of the Company’s stock for the 5-trading day period ending on the last trading day immediately preceding the relevant Term Loan funding). The Warrants may be exercised on a cashless basis and are immediately exercisable through the seventh anniversary of the applicable funding date. The number of shares of common stock for which each Warrant is exercisable and the associated exercise price are subject to certain proportional adjustments as set forth in such Warrant. In connection with the first tranche of the Term Loans, the Company issued a Warrant to Innovatus, exercisable for an aggregate of 477,273 shares of the Company’s common stock at an exercise price of $1.65 per share. The Company evaluated the warrant under ASC 470, Debt, and recognized an additional debt discount of approximately $0.5 million based on the relative fair value of the base instruments and warrants. The Company calculated the fair value of the warrant using the Black-Scholes model. On September 24, 2021, the Company, entered into the First Amendment to Loan and Security Agreement (the “Amendment”) with Innovatus Life Sciences Lending Fund I, LP, which amended the Loan Agreement.. Pursuant to the Amendment, the Company (i) shall prepay an aggregate principal amount of $7.5 million in Term Loans (as defined in the Loan Agreement) in ten consecutive equal monthly installments commencing on December 1, 2021; (ii) shall pay an additional prepayment premium of 5% on prepaid amounts if the Company elects to prepay all outstanding Term Loans on or before September 24, 2023 and (iii) shall maintain minimum liquidity of no less than $5.0 million if the aggregate principal amount of Term Loans is greater than $15.0 million pursuant to the liquidity covenant in the Loan Agreement. As of September 30, 2021, the outstanding balance of the Term Loan was $21.2 million, net of unamortized issuance costs and unaccreted discount of $1.3 million. The following table reflects the schedule of principal payments on the Term Loan as of September 30, 2021 (in thousands): Principal Payments 2021 $ 1,500 2022 7,500 2023 6,000 2024 6,000 2025 1,500 $ 22,500

Insurance Financing Note Payabl

Insurance Financing Note Payable	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Insurance Financing Note Payable	Insurance Financing Note PayableOn July 3, 2021, the Company entered into a short-term note payable for $2.0 million, bearing interest at 3.93% per annum to finance various insurance policies. Principal and interest payments related to this note will begin on July 3, 2021 and are paid on a straight-line amortization over 9 months with the final payment due on March 3, 2022. As of September 30, 2021, the Company's insurance note payable balance was $1.3 million.

Basis of Presentation, Summar_2

Basis of Presentation, Summary of Significant Accounting Policies and Recent Accounting Pronouncements (Policies)	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Basis of Presentation	The accompanying condensed consolidated interim financial statements include the accounts of the Company and its subsidiaries. All material intercompany balances and transactions have been eliminated in consolidation.
Use of Estimates	Use of Estimates The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that may affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of expenses during the reporting period. Actual results could differ from those estimates.
Leases	Leases The Company accounts for its leases under Accounting Standards Codification (“ASC”) 842, Leases . Under this guidance, arrangements meeting the definition of a lease are classified as operating or financing leases and are recorded on the consolidated balance sheet as both a right-of-use asset and lease liability, calculated by discounting fixed lease payments over the lease term at the rate implicit in the lease or the Company’s incremental borrowing rate. Lease liabilities are increased by interest and reduced by payments each period, and the right-of-use asset is amortized over the lease term. For operating leases, interest on the lease liability and the amortization of the right-of-use asset result in straight-line rent expense over the lease term. Variable lease expenses, if any, are recorded when incurred.
Loss Per Share	Loss Per Share ASC 260, Earnings Per Share , requires dual presentation of basic and diluted earnings per share (“EPS”), with a reconciliation of the numerator and denominator of the basic EPS computation to the numerator and denominator of the diluted EPS computation. Basic EPS excludes dilution. Diluted EPS reflects the potential dilution that could occur if securities or other contracts to issue common stock were exercised or converted into common stock or resulted in the issuance of common stock that are then sharing in the earnings of the entity.
Adoption of Recent Accounting Pronouncements	Adoption of Recent Accounting Pronouncements The Company continually assesses new accounting pronouncements to determine their applicability. When it is determined that a new accounting pronouncement affects the Company’s financial reporting, the Company undertakes a review to determine the consequences of the change to its consolidated financial statements and assures that there are sufficient controls in place to ascertain that the Company’s consolidated financial statements properly reflect the change. In April 2021, the Financial Accounting Standards Board ("FASB") recently issued Accounting Standards Update ("ASU") 2021-04 to codify the final consensus reached by the Emerging Issues Task Force (EITF) on how an issuer should account for modifications made to equity-classified written call options (hereafter referred to as a warrant to purchase the issuer’s common stock). The guidance in the ASU requires the issuer to treat a modification of an equity-classified warrant that does not cause the warrant to become liability-classified as an exchange of the original warrant for a new warrant. This guidance applies whether the modification is structured as an amendment to the terms and conditions of the warrant or as termination of the original warrant and issuance of a new warrant. The Company is evaluating the impact of this guidance on its condensed consolidated financial statements.

Basis of Presentation, Summar_3

Basis of Presentation, Summary of Significant Accounting Policies and Recent Accounting Pronouncements (Tables)	9 Months Ended
	Sep. 30, 2021
Accounting Policies [Abstract]
Summary of Potentially Dilutive Securities	Securities that could potentially dilute net income per share in the future that were not included in the computation of diluted loss per share were as follows: As of September 30, 2021 2020 Options to purchase common stock 5,871,620 6,682,192 Unvested restricted stock awards 78,300 146,800 Unvested restricted stock units 342,271 245,405 Warrants to purchase common stock 26,426,863 26,426,863 Total 32,719,054 33,501,260

Revenue Recognition (Tables)

Revenue Recognition (Tables)	9 Months Ended
	Sep. 30, 2021
Revenue from Contract with Customer [Abstract]
Disaggregation of Revenue	Revenue is disaggregated by primary geographical market, major product line, and timing of revenue recognition. In thousands of U.S. dollars ($) Three Months Ended September 30, 2021 Nine Months Ended September 30, 2021 Products By Geographic Area Total U.S. Rest of World Total U.S. Rest of World Drug Revenues Product Sales – Point-in-time $ 217 $ 217 $ — $ 656 $ 656 $ — License Fee – Over time 62 — 62 179 — 179 Total Drug Products 279 217 62 835 656 179 Concentrate Products Product Sales – Point-in-time 15,224 13,541 1,683 44,308 39,768 4,540 License Fee – Over time 485 485 — 1,456 1,456 — Total Concentrate Products 15,709 14,026 1,683 45,764 41,224 4,540 Net Revenue $ 15,988 $ 14,243 $ 1,745 $ 46,599 $ 41,880 $ 4,719 In thousands of U.S. dollars ($) Three Months Ended September 30, 2020 Nine Months Ended September 30, 2020 Products By Geographic Area Total U.S. Rest of World Total U.S. Rest of World Drug Revenues Product Sales – Point-in-time $ 228 $ 228 $ — $ 609 $ 609 $ — License Fee – Over time 56 — 56 167 — 167 Total Drug Products 284 228 56 776 609 167 Concentrate Products Product Sales – Point-in-time 14,506 13,470 1,036 44,786 40,295 4,491 License Fee – Over time 490 490 — 1,471 1,471 — Total Concentrate Products 14,996 13,960 1,036 46,257 41,766 4,491 Net Revenue $ 15,280 $ 14,188 $ 1,092 $ 47,033 $ 42,375 $ 4,658
Contract Balances	The following table provides information about receivables, contract assets, and contract liabilities from contracts with customers. In thousands of U.S. dollars ($) September 30, 2021 December 31, 2020 Receivables, which are included in "Trade and other receivables" $ 6,036 $ 4,171 Contract liabilities $ 8,705 $ 10,190

Investments - Available-for-S_2

Investments - Available-for-Sale (Tables)	9 Months Ended
	Sep. 30, 2021
Investments, Debt and Equity Securities [Abstract]
Investments Available-for-Sale	Investments available-for-sale consisted of the following as of September 30, 2021 and December 31, 2020 (table in thousands): September 30, 2021 Amortized Cost Unrealized Gain Unrealized Loss Accrued Interest Income Fair Value Available-for-Sale Securities Bonds $ 9,805 $ 1 $ — $ 7 $ 9,813 December 31, 2020 Amortized Cost Unrealized Gain Unrealized Loss Accrued Interest Fair Value Available-for-Sale Securities Bonds $ 9,987 $ 3 $ — $ 7 $ 9,997

Inventory (Tables)

Inventory (Tables)	9 Months Ended
	Sep. 30, 2021
Inventory Disclosure [Abstract]
Schedule Components of Inventory	Components of inventory, net of reserves, as of September 30, 2021 and December 31, 2020 are as follows (table in thousands): September 30, December 31, Raw Materials $ 3,507 $ 3,112 Work in Process 266 172 Finished Goods 1,781 1,805 Total $ 5,554 $ 5,089

Property and Equipment (Tables)

Property and Equipment (Tables)	9 Months Ended
	Sep. 30, 2021
Property, Plant and Equipment [Abstract]
Schedule of Major Classes of Property and Equipment	As of September 30, 2021 and December 31, 2020, the Company’s property and equipment consisted of the following (table in thousands): September 30, December 31, Leasehold Improvements $ 1,196 $ 1,196 Machinery and Equipment 5,794 5,475 Information Technology & Office Equipment 1,846 1,831 Laboratory Equipment 676 676 9,512 9,178 Accumulated Depreciation (7,005) (6,536) Property and Equipment, net $ 2,507 $ 2,642

Accrued Liabilities (Tables)

Accrued Liabilities (Tables)	9 Months Ended
	Sep. 30, 2021
Payables and Accruals [Abstract]
Schedule of Accrued Liabilities	Accrued liabilities as of September 30, 2021 and December 31, 2020 consisted of the following (table in thousands): September 30, December 31, Accrued Research & Development Expense $ 181 $ 232 Accrued Compensation and Benefits 2,193 2,500 Accrued Unvouchered Receipts 622 755 Accrued Workers Compensation 434 395 Other Accrued Liabilities 941 1,131 Total Accrued Liabilities $ 4,371 $ 5,013

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2021
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Schedule of Total Stock-Based Compensation Expense	The Company recognized total stock-based compensation expense during the three and nine months ended September 30, 2021 and 2020 as follows (table in thousands): Three Months Ended Nine Months Ended 2021 2020 2021 2020 Service-based awards: Restricted stock units $ 81 $ 9 $ 263 $ 243 Stock option awards 315 243 1,050 1,019 396 252 1,313 1,262 Performance-based awards: Restricted stock awards — — (391) — Restricted stock units — (123) — (1,148) Stock option awards (35) 121 (364) (390) (35) (2) (755) (1,538) Total $ 361 $ 250 $ 558 $ (276)
Restricted stock awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Schedule of Restricted Stock Awards	A summary of the Company’s restricted stock awards during the nine months ended September 30, 2021 is as follows: Number of Shares Weighted Average Unvested at January 1, 2021 146,800 $ 5.70 Forfeited (68,500) $ 5.70 Unvested at September 30, 2021 78,300 $ 5.70 A summary of the Company’s restricted stock awards during the nine months ended September 30, 2020 is as follows: Number of Shares Weighted Average Unvested at January 1, 2020 146,800 $ 5.70 Unvested at September 30, 2020 146,800 $ 5.70
Restricted stock units - service based awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Schedule of Restricted Stock Awards	A summary of the Company’s service-based restricted stock units during the nine months ended September 30, 2021 is as follows: Number of Shares Weighted Average Unvested at January 1, 2021 265,494 $ 2.60 Granted 310,050 0.90 Vested (221,474) 2.38 Forfeited (11,799) 4.81 Unvested at September 30, 2021 342,271 $ 1.17 A summary of the Company’s service-based restricted stock units during the nine months ended September 30, 2020 is as follows: Number of Shares Weighted Average Unvested at January 1, 2020 463,786 $ 4.26 Granted 188,904 2.09 Vested (247,561) 4.30 Forfeited (159,724) 4.26 Unvested at September 30, 2020 245,405 $ 2.72
Restricted stock units - performance based awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Schedule of Restricted Stock Awards	A summary of the Company’s performance-based restricted stock units during the nine months ended September 30, 2020 is as follows: Number of Shares Weighted Average Unvested at January 1, 2020 988,958 $ 4.48 Forfeited (988,958) 4.48 Unvested at Unvested at September 30, 2020 — $ —
Stock option awards - service based awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Schedule of Stock Option Assumptions	The fair value of the service-based stock options granted for the nine months ended September 30, 2021 were based on the following assumptions: September 30, Exercise price $0.61 - $1.73 Expected stock price volatility 75.8% - 77.7% Risk-free interest rate 0.47% - 1.06% Term (years) 5.5 - 6
Schedule of Stock Options Activity	A summary of the Company’s service-based stock option activity for the nine months ended September 30, 2021 is as follows: Shares Weighted Weighted Aggregate Outstanding at January 1, 2021 5,717,956 $ 4.55 6.6 $ — Granted 1,872,162 0.89 6.0 — Forfeited (385,278) 2.30 — — Expired (1,333,220) 7.16 — — Outstanding at September 30, 2021 5,871,620 $ 2.95 7.7 $ — Exercisable at September 30, 2021 2,539,438 $ 4.96 5.8 $ — A summary of the Company’s service-based stock option activity for the nine months ended September 30, 2020 is as follows: Shares Weighted Weighted Aggregate Outstanding at January 1, 2020 8,210,024 $ 7.06 5.1 $ 107,000 Granted 2,252,344 1.95 5.9 — Forfeited (440,026) 3.96 — — Expired (4,090,150) 8.24 — — Outstanding at September 30, 2020 5,932,192 $ 4.54 6.7 $ — Exercisable at September 30, 2020 2,889,218 $ 6.95 3.8 $ —
Stock option awards - performance based awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Schedule of Stock Options Activity	A summary of the performance-based stock options for the nine months ended September 30, 2021 is as follows: Number of Shares Weighted Average Outstanding at January 1, 2021 750,000 $ 2.20 Expired (750,000) 2.20 Outstanding at September 30, 2021 — $ — Exercisable at September 30, 2021 — $ — A summary of the performance-based stock options for the nine months ended September 30, 2020 is as follows: Number of Shares Weighted Average Outstanding at January 1, 2020 388,125 $ 4.70 Granted 750,000 $ 2.20 Forfeited (388,125) $ 4.70 Outstanding at September 30, 2020 750,000 $ 2.20 Exercisable at September 30, 2020 — $ —

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
Summary of Lease Costs	The following summarizes quantitative information about the Company’s operating leases (table in thousands): Three Months Ended September 30, 2021 Three Months Ended September 30, 2020 Nine Months Ended September 30, 2021 Nine Months Ended September 30, 2020 Operating leases Operating lease cost $ 457 $ 382 $ 1,309 $ 1,228 Variable lease cost 94 90 286 403 Operating lease expense 551 472 1,595 1,631 Finance leases Amortization of right-of-use assets 73 — 184 — Interest on lease obligations 22 — 55 — Finance lease expense 95 — 239 — Short-term lease rent expense 4 4 12 12 Total rent expense $ 650 $ 476 $ 1,846 $ 1,643 Other information Operating cash flows from operating leases $ 444 $ 393 $ 1,298 $ 1,248 Operating cash flows from finance leases $ 22 $ — $ 56 $ — Financing cash flows from finance leases $ 59 $ — $ 152 $ — Right of use assets exchanged for operating lease liabilities $ 718 $ — $ 4,089 $ — Right of use assets exchanged for finance lease liabilities $ 588 $ — $ 1,365 $ — Weighted-average remaining lease term – operating leases 3.7 2.3 3.7 2.3 Weighted-average remaining lease term – finance leases 5.5 0.0 5.5 0.0 Weighted-average discount rate – operating leases 6.3 % 6.8 % 6.3 % 6.8 % Weighted-average discount rate – finance leases 5.9 % — % 5.9 % — %
Operating Lease Maturities	Future minimum rental payments under operating lease agreements are as follows (in thousands): Operating Finance Year ending December 31, 2021 (remaining) $ 470 $ 103 Year ending December 31, 2022 1,746 418 Year ending December 31, 2023 1,429 424 Year ending December 31, 2024 1,076 424 Year ending December 31, 2025 616 426 Remaining future payments 345 526 Total $ 5,682 $ 2,321 Less present value discount (607) (338) Operating and finance lease liabilities $ 5,075 $ 1,983
Finance Lease Maturities	Future minimum rental payments under operating lease agreements are as follows (in thousands): Operating Finance Year ending December 31, 2021 (remaining) $ 470 $ 103 Year ending December 31, 2022 1,746 418 Year ending December 31, 2023 1,429 424 Year ending December 31, 2024 1,076 424 Year ending December 31, 2025 616 426 Remaining future payments 345 526 Total $ 5,682 $ 2,321 Less present value discount (607) (338) Operating and finance lease liabilities $ 5,075 $ 1,983

Loans and Security Agreement (T

Loans and Security Agreement (Tables)	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Schedule of Principal Payments on Term Loan	The following table reflects the schedule of principal payments on the Term Loan as of September 30, 2021 (in thousands): Principal Payments 2021 $ 1,500 2022 7,500 2023 6,000 2024 6,000 2025 1,500 $ 22,500

Description of Business (Detail

Description of Business (Details) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2021USD ($)employee	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)employee	Sep. 30, 2020USD ($)	Dec. 31, 2020USD ($)
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Net Revenue | $	$ 15,988	$ 15,280	$ 46,599	$ 47,033	$ 60,000
Years of service			25 years
Number of employees | employee	300		300

Liquidity and Capital Resourc_2

Liquidity and Capital Resources (Details) $ / shares in Units, $ in Thousands	5 Months Ended	9 Months Ended
	Dec. 08, 2021businessDay$ / shares	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)	Jun. 30, 2021USD ($)	Mar. 31, 2021USD ($)	Dec. 31, 2020USD ($)	Jun. 30, 2020USD ($)	Mar. 31, 2020USD ($)	Dec. 31, 2019USD ($)
Liquidity and Capital Resources [Line Items]
Accumulated deficit		$ (361,139)				$ (337,406)
Stockholders' equity		11,094	$ 42,075	$ 18,203	$ 26,178	$ 34,170	$ 16,211	$ 21,774	$ 20,320
Cash, cash equivalents and investments available-for-sale		33,200
Working capital		24,300
Net cash used in operating activities		$ (24,508)	$ (21,072)
Subsequent event
Liquidity and Capital Resources [Line Items]
Period to regain Nasdaq minimum bid requirements	180 days
Common stock, closing bid price (at least) (in dollars per share) | $ / shares	$ (1)
Number of consecutive business days (minimum) | businessDay	10

Basis of Presentation, Summar_4

Basis of Presentation, Summary of Significant Accounting Policies and Recent Accounting Pronouncements - Summary of Potentially Dilutive Securities (Details) - shares	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Net Earnings per Share
Securities excluded from diluted loss per share calculation (in shares)	32,719,054	33,501,260
Options to purchase common stock
Net Earnings per Share
Securities excluded from diluted loss per share calculation (in shares)	5,871,620	6,682,192
Unvested restricted stock awards
Net Earnings per Share
Securities excluded from diluted loss per share calculation (in shares)	78,300	146,800
Unvested restricted stock units
Net Earnings per Share
Securities excluded from diluted loss per share calculation (in shares)	342,271	245,405
Warrants to purchase common stock
Net Earnings per Share
Securities excluded from diluted loss per share calculation (in shares)	26,426,863	26,426,863

Revenue Recognition - Nature of

Revenue Recognition - Nature of Goods and Services (Details)	9 Months Ended
	Sep. 30, 2021agreement
Revenue from Contract with Customer [Abstract]
Number of distribution and license agreements	5
Customers average payment term	30 days
Distributors average payment term	45 days

Revenue Recognition - Disaggreg

Revenue Recognition - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Disaggregation of Revenue [Line Items]
Net Revenue	$ 15,988	$ 15,280	$ 46,599	$ 47,033	$ 60,000
Drug products
Disaggregation of Revenue [Line Items]
Net Revenue	279	284	835	776
Concentrate Products
Disaggregation of Revenue [Line Items]
Net Revenue	15,709	14,996	45,764	46,257
U.S.
Disaggregation of Revenue [Line Items]
Net Revenue	14,243	14,188	41,880	42,375
U.S. | Drug products
Disaggregation of Revenue [Line Items]
Net Revenue	217	228	656	609
U.S. | Concentrate Products
Disaggregation of Revenue [Line Items]
Net Revenue	14,026	13,960	41,224	41,766
Rest of World
Disaggregation of Revenue [Line Items]
Net Revenue	1,745	1,092	4,719	4,658
Rest of World | Drug products
Disaggregation of Revenue [Line Items]
Net Revenue	62	56	179	167
Rest of World | Concentrate Products
Disaggregation of Revenue [Line Items]
Net Revenue	1,683	1,036	4,540	4,491
Product Sales – Point-in-time | Drug product sales
Disaggregation of Revenue [Line Items]
Net Revenue	217	228	656	609
Product Sales – Point-in-time | Concentrate product sales
Disaggregation of Revenue [Line Items]
Net Revenue	15,224	14,506	44,308	44,786
Product Sales – Point-in-time | U.S. | Drug product sales
Disaggregation of Revenue [Line Items]
Net Revenue	217	228	656	609
Product Sales – Point-in-time | U.S. | Concentrate product sales
Disaggregation of Revenue [Line Items]
Net Revenue	13,541	13,470	39,768	40,295
Product Sales – Point-in-time | Rest of World | Drug product sales
Disaggregation of Revenue [Line Items]
Net Revenue	0	0	0	0
Product Sales – Point-in-time | Rest of World | Concentrate product sales
Disaggregation of Revenue [Line Items]
Net Revenue	1,683	1,036	4,540	4,491
License Fee – Over time | Drug license fee
Disaggregation of Revenue [Line Items]
Net Revenue	62	56	179	167
License Fee – Over time | Concentrate product license fee
Disaggregation of Revenue [Line Items]
Net Revenue	485	490	1,456	1,471
License Fee – Over time | U.S. | Drug license fee
Disaggregation of Revenue [Line Items]
Net Revenue	0	0	0	0
License Fee – Over time | U.S. | Concentrate product license fee
Disaggregation of Revenue [Line Items]
Net Revenue	485	490	1,456	1,471
License Fee – Over time | Rest of World | Drug license fee
Disaggregation of Revenue [Line Items]
Net Revenue	62	56	179	167
License Fee – Over time | Rest of World | Concentrate product license fee
Disaggregation of Revenue [Line Items]
Net Revenue	$ 0	$ 0	$ 0	$ 0

Revenue Recognition - Contract

Revenue Recognition - Contract Balances (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Revenue from Contract with Customer [Abstract]
Receivables, which are included in "Trade and other receivables"	$ 6,036	$ 4,171
Contract liabilities	$ 8,705	$ 10,190

Revenue Recognition - Narrative

Revenue Recognition - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Revenue Recognition [Line Items]
Impairment losses	$ 0	$ 0	$ 0	$ 0
Contract assets	0		0		$ 0
Revenue performance obligation	8.7		8.7
Baxter Healthcare Organization
Revenue Recognition [Line Items]
Revenue performance obligation	5.7		5.7
Concentrate Products
Revenue Recognition [Line Items]
Reserve for returns	$ 0		$ 0		$ 0

Investments - Available-for-S_3

Investments - Available-for-Sale (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Investments, Debt and Equity Securities [Abstract]
Amortized Cost	$ 9,805	$ 9,987
Unrealized Gain	1	3
Unrealized Loss	0	0
Accrued Interest Income	7	7
Fair Value	$ 9,813	$ 9,997

Inventory (Details)

Inventory (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Inventory [Line Items]
Raw Materials	$ 3,507	$ 3,112
Work in Process	266	172
Finished Goods	1,781	1,805
Total	5,554	5,089
Inventory, noncurrent	1,526	1,176
Inventory, net	4,028	$ 3,913
Triferic Inventory
Inventory [Line Items]
Raw Materials	900
Inventory, noncurrent	1,500
Inventory, net	1,600
Triferic Dialysate
Inventory [Line Items]
Finished Goods	400
Triferic API
Inventory [Line Items]
Inventory, net	$ 400

Property and Equipment (Details

Property and Equipment (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Property and equipment
Gross property and equipment	$ 9,512		$ 9,512		$ 9,178
Accumulated Depreciation	(7,005)		(7,005)		(6,536)
Property and Equipment, net	2,507		2,507		2,642
Depreciation expense	100	$ 200	500	$ 600
Leasehold Improvements
Property and equipment
Gross property and equipment	1,196		1,196		1,196
Machinery and Equipment
Property and equipment
Gross property and equipment	5,794		5,794		5,475
Information Technology & Office Equipment
Property and equipment
Gross property and equipment	1,846		1,846		1,831
Laboratory Equipment
Property and equipment
Gross property and equipment	$ 676		$ 676		$ 676

Accrued Liabilities (Details)

Accrued Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Payables and Accruals [Abstract]
Accrued Research & Development Expense	$ 181	$ 232
Accrued Compensation and Benefits	2,193	2,500
Accrued Unvouchered Receipts	622	755
Accrued Workers Compensation	434	395
Other Accrued Liabilities	941	1,131
Total Accrued Liabilities	$ 4,371	$ 5,013

Deferred Revenue (Details)

Deferred Revenue (Details) - USD ($)	1 Months Ended				3 Months Ended		9 Months Ended		12 Months Ended
	Jun. 30, 2021	Sep. 30, 2020	Jan. 31, 2020	Oct. 31, 2014	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2016	Dec. 31, 2020
Deferred Revenue Arrangement [Line Items]
Deferred revenue					$ 8,705,000		$ 8,705,000			$ 10,190,000
Baxter Healthcare Organization
Deferred Revenue Arrangement [Line Items]
Upfront payment				$ 20,000,000
Recognized deferred revenue					500,000	$ 1,500,000	500,000	$ 1,500,000
Deferred revenue					5,700,000		$ 5,700,000			7,200,000
Refund percentage							25.00%
Wanbang Biopharmaceutical
Deferred Revenue Arrangement [Line Items]
Upfront payment									$ 4,000,000
Recognized deferred revenue					53,000	200,000	$ 53,000	200,000
Deferred revenue					2,600,000		2,600,000			2,700,000
Sun Pharma Agreements
Deferred Revenue Arrangement [Line Items]
Upfront payment			$ 100,000
Recognized deferred revenue					2,500	7,500	2,500	7,500
Deferred revenue					82,500		82,500			90,000
Jeil Pharma Agreements
Deferred Revenue Arrangement [Line Items]
Upfront payment		$ 200,000
Recognized deferred revenue					2,500	$ 0	7,500	$ 0
Deferred revenue					200,000		200,000			$ 200,000
Drogsan Agreements
Deferred Revenue Arrangement [Line Items]
Upfront payment	$ 150,000
Recognized deferred revenue					3,750
Deferred revenue					$ 150,000		$ 150,000

Stockholders_ Equity (Details)

Stockholders’ Equity (Details) - USD ($)	Mar. 22, 2019	Sep. 30, 2021	Sep. 30, 2021	Dec. 31, 2020
Class of Stock [Line Items]
Preferred stock, authorized (in shares)		2,000,000	2,000,000	2,000,000
Preferred shares, par value (in dollars per share)		$ 0.0001	$ 0.0001	$ 0.0001
Preferred shares, shares issued (in shares)		0	0	0
Preferred shares, shares outstanding (in shares)		0	0	0
Common shares, shares authorized (in shares)		170,000,000	170,000,000	170,000,000
Common shares, par value (in dollars per share)		$ 0.0001	$ 0.0001	$ 0.0001
Common shares, shares issued (in shares)		93,966,381	93,966,381	93,573,165
Common shares, shares outstanding (in shares)		93,966,381	93,966,381	93,573,165
At-the-Market Offering
Class of Stock [Line Items]
Remaining amount available for sale		$ 32,300,000	$ 32,300,000
At-the-Market Offering | Maximum
Class of Stock [Line Items]
Sales agreement, threshold sale of shares	$ 40,000,000

Stock-Based Compensation - Shar

Stock-Based Compensation - Share-Based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total share based compensation expense	$ 361	$ 250	$ 558	$ (276)
Service based awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total share based compensation expense	396	252	1,313	1,262
Restricted stock units - service based awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total share based compensation expense	81	9	263	243
Stock option awards - service based awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total share based compensation expense	315	243	1,050	1,019
Performance based awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total share based compensation expense	(35)	(2)	(755)	(1,538)
Restricted stock awards - performance based awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total share based compensation expense	0	0	(391)	0
Restricted stock units - performance based awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total share based compensation expense	0	(123)	0	(1,148)
Stock option awards - performance based awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total share based compensation expense	$ (35)	$ 121	$ (364)	$ (390)

Stock-Based Compensation - Rest

Stock-Based Compensation - Restricted Stock Awards (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Weighted Average Grant-Date Fair Value
Stock based compensation expenses	$ 361	$ 250	$ 558	$ (276)
Restricted stock awards
Number of Shares
Unvested at beginning of period (in shares)			146,800	146,800
Forfeited (in shares)			(68,500)
Unvested at end of period (in shares)	78,300	146,800	78,300	146,800
Weighted Average Grant-Date Fair Value
Unvested at beginning of period (in dollars per share)			$ 5.70	$ 5.70
Forfeited (in dollars per share)			5.70
Unvested at end of period (in dollars per share)	$ 5.70	$ 5.70	$ 5.70	$ 5.70
Vesting period			20 months
Unvested, number of shares (in shares)	78,300	146,800	78,300	146,800
Forfeited (in shares)			(68,500)
Restricted stock awards - performance based awards
Number of Shares
Forfeited (in shares)			(68,500)
Unvested at end of period (in shares)	78,300		78,300
Weighted Average Grant-Date Fair Value
Unvested, number of shares (in shares)	78,300		78,300
Forfeited (in shares)			(68,500)
Stock based compensation expenses	$ 0	$ 0	$ (391)	$ 0

Stock-Based Compensation - Serv

Stock-Based Compensation - Service Based and Performance Based Restricted Stock Units (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Weighted Average Grant-Date Fair Value
Stock based compensation expenses	$ 361	$ 250	$ 558	$ (276)
Restricted stock units - service based awards
Number of Shares
Unvested at beginning of period (in shares)			265,494	463,786
Granted (in shares)			310,050	188,904
Vested (in shares)			(221,474)	(247,561)
Forfeited (in shares)			(11,799)	(159,724)
Unvested at end of period (in shares)	342,271	245,405	342,271	245,405
Weighted Average Grant-Date Fair Value
Unvested at beginning of period (in dollars per share)			$ 2.60	$ 4.26
Granted (in dollars per share)			0.90	2.09
Vested (in dollars per share)			2.38	4.30
Forfeited (in dollars per share)			4.81	4.26
Unvested at end of period (in dollars per share)	$ 1.17	$ 2.72	$ 1.17	$ 2.72
Stock based compensation expenses	$ 81	$ 9	$ 263	$ 243
Unrecognized stock-based compensation expense	200		$ 200
Unrecognized stock-based compensation expense, weighted average remaining term (in years) (less than)			1 year
Restricted stock units - service based awards | Minimum
Weighted Average Grant-Date Fair Value
Vesting period			1 year
Restricted stock units - service based awards | Maximum
Weighted Average Grant-Date Fair Value
Vesting period			3 years
Restricted stock units - performance based awards
Number of Shares
Unvested at beginning of period (in shares)				988,958
Forfeited (in shares)				(988,958)
Unvested at end of period (in shares)		0		0
Weighted Average Grant-Date Fair Value
Unvested at beginning of period (in dollars per share)				$ 4.48
Forfeited (in dollars per share)				4.48
Unvested at end of period (in dollars per share)		$ 0		$ 0
Stock based compensation expenses	$ 0	$ (123)	$ 0	$ (1,148)
Outstanding performance-based restricted stock units (in shares)	0		0

Stock-Based Compensation - Se_2

Stock-Based Compensation - Service Based Stock Options - Fair Value Assumptions (Details) - Stock option awards - service based awards	9 Months Ended
	Sep. 30, 2021$ / shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected stock price volatility, minimum	75.80%
Expected stock price volatility, maximum	77.70%
Risk-free interest rate, minimum	0.47%
Risk-free interest rate, maximum	1.06%
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exercise price (in dollars per share)	$ 0.61
Term (years)	5 years 6 months
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exercise price (in dollars per share)	$ 1.73
Term (years)	6 years

Stock-Based Compensation - Se_3

Stock-Based Compensation - Service Based Stock Options (Details) - Stock option awards - service based awards - USD ($)	9 Months Ended		12 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020	Dec. 31, 2019
Shares Underlying Options
Outstanding at the beginning of the period (in shares)	5,717,956	8,210,024	8,210,024
Granted (in shares)	1,872,162	2,252,344
Forfeited (in shares)	(385,278)	(440,026)
Expired (in shares)	(1,333,220)	(4,090,150)
Outstanding at the end of the period (in shares)	5,871,620	5,932,192	5,717,956	8,210,024
Exercisable at end of period (in shares)	2,539,438	2,889,218
Weighted Average Exercise Price
Outstanding at the beginning of the period (in dollars per share)	$ 4.55	$ 7.06	$ 7.06
Granted (in dollars per share)	0.89	1.95
Forfeited (in dollars per share)	2.30	3.96
Expired (in dollar per share)	7.16	8.24
Outstanding at the end of the period (in dollars per share)	2.95	4.54	$ 4.55	$ 7.06
Exercisable at end of the period (in dollars per share)	$ 4.96	$ 6.95
Weighted Average Remaining Contractual Term
Outstanding	7 years 8 months 12 days	6 years 8 months 12 days	6 years 7 months 6 days	5 years 1 month 6 days
Granted	6 years	5 years 10 months 24 days
Exercisable at end of the period	5 years 9 months 18 days	3 years 9 months 18 days
Aggregate Intrinsic Value
Outstanding	$ 0	$ 0	$ 0	$ 107,000
Exercisable at end of the period	$ 0	$ 0

Stock-Based Compensation - Se_4

Stock-Based Compensation - Service Based Stock Options - Others (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock based compensation expenses	$ 361	$ 250	$ 558	$ (276)
Stock option awards - service based awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)			1,872,162	2,252,344
Forfeited (in shares)			385,278	440,026
Expirations (in shares)			1,333,220	4,090,150
Stock based compensation expenses	315	$ 243	$ 1,050	$ 1,019
Unrecognized stock-based compensation expenses	$ 1,700		$ 1,700
Unrecognized stock-based compensation expense, weighted average remaining term (in years)			3 years

Stock-Based Compensation - Perf

Stock-Based Compensation - Performance Based Stock Options (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Weighted Average Exercise Price
Stock based compensation expenses	$ 361,000	$ 250,000	$ 558,000	$ (276,000)
Stock option awards - performance based awards
Number of Shares
Outstanding at the beginning of the period (in shares)			750,000	388,125
Expired (in shares)			(750,000)
Granted (in shares)				750,000
Forfeited (in shares)				(388,125)
Outstanding at the end of the period (in shares)	0	750,000	0	750,000
Exercisable at end of period (in shares)	0	0	0	0
Weighted Average Exercise Price
Outstanding at the beginning of the period (in dollars per share)			$ 2.20	$ 4.70
Expired (in dollar per share)			2.20
Granted (in dollars per share)				2.20
Forfeited (in dollars per share)				4.70
Outstanding at the end of the period (in dollars per share)	$ 0	$ 2.20	0	2.20
Exercisable at end of the period (in dollars per share)	$ 0	$ 0	$ 0	$ 0
Stock based compensation expenses	$ (35,000)	$ 121,000	$ (364,000)	$ (390,000)
Unrecognized stock-based compensation expenses	$ 0		$ 0

Licensing Agreements (Details)

Licensing Agreements (Details) $ in Thousands	Oct. 07, 2018USD ($)installmentagreement	Dec. 31, 2019USD ($)	Sep. 30, 2021USD ($)	Jul. 15, 2019USD ($)	Apr. 15, 2019USD ($)	Jan. 15, 2019USD ($)	Oct. 15, 2018USD ($)
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Number of additional agreements | agreement	3
Collaborative arrangement, accrued reimbursement of IP expenses and sublicense royalty fees			$ 200
Executive vice president and chief scientific officer
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total amount due	$ 1,000			$ 250	$ 250	$ 250	$ 250
Number of quarterly installment payments | installment	4
Installment paid		$ 1,000
Collaborative arrangement, accrued reimbursement of legal expenses		$ 100

Leases - Narrative (Details)

Leases - Narrative (Details) $ in Thousands	Sep. 30, 2021USD ($)ft²	Dec. 31, 2020USD ($)
Lessee, Lease, Description [Line Items]
Operating lease and finance lease liabilities | $	$ 7,100
Operating lease and finance lease, right of use assets, net | $	6,934	$ 2,911
Operating lease liabilities | $	$ 5,075	3,000
Operating lease, right of use assets | $		$ 2,900
Wixom, Michigan | Wixom, Michigan Property One
Lessee, Lease, Description [Line Items]
Facility sqft.	51,000
Wixom, Michigan | Wixom, Michigan Property Two
Lessee, Lease, Description [Line Items]
Facility sqft.	17,500
Grapevine, Texas
Lessee, Lease, Description [Line Items]
Facility sqft.	51,000
Greer, South Carolina
Lessee, Lease, Description [Line Items]
Facility sqft.	57,000
Hackensack, New Jersey
Lessee, Lease, Description [Line Items]
Facility sqft.	4,100
Maximum
Lessee, Lease, Description [Line Items]
Lease term	5 years

Leases - Summary of Lease Costs

Leases - Summary of Lease Costs (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Operating leases
Operating lease cost	$ 457	$ 382	$ 1,309	$ 1,228
Variable lease cost	94	90	286	403
Operating lease expense	551	472	1,595	1,631
Finance leases
Amortization of right-of-use assets	73	0	184	0
Interest on lease obligations	22	0	55	0
Finance lease expense	95	0	239	0
Short-term lease rent expense	4	4	12	12
Total rent expense	650	476	1,846	1,643
Other information
Operating cash flows from operating leases	444	393	1,298	1,248
Operating cash flows from finance leases	22	0	56	0
Financing cash flows from finance leases	59	0	152	0
Right of use assets exchanged for operating lease liabilities	718	0	4,089	0
Right of use assets exchanged for finance lease liabilities	$ 588	$ 0	$ 1,365	$ 0
Weighted-average remaining lease term – operating leases	3 years 8 months 12 days	2 years 3 months 18 days	3 years 8 months 12 days	2 years 3 months 18 days
Weighted-average remaining lease term – finance leases	5 years 6 months	0 years	5 years 6 months	0 years
Weighted-average discount rate – operating leases	6.30%	6.80%	6.30%	6.80%
Weighted-average discount rate – finance leases	5.90%	0.00%	5.90%	0.00%

Leases - Finance Lease and Oper

Leases - Finance Lease and Operating Lease Maturities (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Operating
Year ending December 31, 2021 (remaining)	$ 470
Year ending December 31, 2022	1,746
Year ending December 31, 2023	1,429
Year ending December 31, 2024	1,076
Year ending December 31, 2025	616
Remaining future payments	345
Total	5,682
Less present value discount	(607)
Operating lease liabilities	5,075	$ 3,000
Finance
Year ending December 31, 2021 (remaining)	103
Year ending December 31, 2022	418
Year ending December 31, 2023	424
Year ending December 31, 2024	424
Year ending December 31, 2025	426
Remaining future payments	526
Total	2,321
Less present value discount	(338)
Finance lease liabilities	$ 1,983

Loans and Security Agreement -

Loans and Security Agreement - Narrative (Details) - Term loan	Sep. 24, 2021USD ($)installment	Mar. 16, 2020USD ($)$ / sharesshares	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)	Mar. 31, 2020USD ($)
Term loan
Debt Instrument [Line Items]
Aggregate principal amount	$ 7,500,000						$ 35,000,000
Interest rate, base percentage		4.75%
Interest rate, additional percentage added to base percentage		4.00%
Initial interest rate percentage		8.75%
Effective interest rate		11.30%
Option to add interest rate amount to outstanding principal balance in lieu of paying such amount in cash, percentage		1.00%
Interest expense			$ 600,000	$ 700,000	$ 1,800,000	$ 1,300,000
Calculation for number of shares of common stock able to be purchased by warrant, percentage of principal amount of relevant term loan funded funded		3.50%
Warrant exercise price calculation, period immediately preceding execution of loan agreement, number of trading days		5 days
Number of monthly installments | installment	10
Prepayment premium percentage	5.00%
Minimum liquidity floor	$ 5,000,000
Minimum principal amount pursuant to liquidity covenant	$ 15,000,000
Outstanding balance, net of unamortized issuance costs and unaccreted discount			21,200,000		21,200,000
Unamortized issuance costs and unaccreted discount			$ 1,300,000		$ 1,300,000
Term loan | Minimum
Debt Instrument [Line Items]
Period for which company is entitled to make interest-only payments		30 months
Term loan | Maximum
Debt Instrument [Line Items]
Period for which company is entitled to make interest-only payments		36 months
Term loan, first tranche
Debt Instrument [Line Items]
Aggregate principal amount		$ 22,500,000
Net draw down proceeds		21,200,000
Closing costs		$ 1,300,000
Exercise price of warrant (in dollars per share) | $ / shares		$ 1.65
Number of shares of common stock for which warrant is exercisable (in shares) | shares		477,273
Additional debt discount recognized		$ 500,000
Term loan, second and third tranches
Debt Instrument [Line Items]
Warrant exercise price calculation, period immediately preceding relevant funding, number of trading days		5 days
Term loan, second and third tranches | Maximum
Debt Instrument [Line Items]
Exercise price of warrant (in dollars per share) | $ / shares		$ 1.65
Term loan, second tranche
Debt Instrument [Line Items]
Aggregate principal amount		$ 5,000,000
Term loan, third tranche
Debt Instrument [Line Items]
Aggregate principal amount		$ 7,500,000

Loans and Security Agreement _2

Loans and Security Agreement - Schedule of Principal Payments on Term Loan (Details) - Term loan - Term loan $ in Thousands	Sep. 30, 2021USD ($)
Debt Instrument [Line Items]
2021	$ 1,500
2022	7,500
2023	6,000
2024	6,000
2025	1,500
Principal Payments	$ 22,500

Insurance Financing Note Paya_2

Insurance Financing Note Payable (Details) - USD ($) $ in Thousands	Jul. 03, 2021	Sep. 30, 2021	Dec. 31, 2020
Short-term Debt [Line Items]
Insurance Financing Note Payable		$ 1,312	$ 0
3.925% Note Payable | Notes Payable to Banks
Short-term Debt [Line Items]
Short-term note payable	$ 2,000
Interest rate, base percentage	3.93%
Amortization period (in months)	9 months