Cytosorbents (CTSO) 10-Q 7 May 19 2019 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2019	Apr. 30, 2019
Document and Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q1
Entity Registrant Name	Cytosorbents Corp
Entity Central Index Key	0001175151
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Trading Symbol	CTSO
Entity Common Stock, Shares Outstanding		32,249,044
Entity Emerging Growth Company	false
Entity Small Business	true

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($)	Mar. 31, 2019	Dec. 31, 2018
Current Assets:
Cash and cash equivalents	$ 19,647,374	$ 22,368,837
Grants and accounts receivable, net of allowance for doubtful accounts of $85,460 at March 31, 2019 and $83,726 at December 31, 2018	3,267,035	3,943,119
Inventories	1,213,606	833,133
Prepaid expenses and other current assets	700,177	1,118,998
Total current assets	24,828,192	28,264,087
Property and equipment, net	1,896,655	1,729,860
Right of use asset	1,359,097	1,449,437
Other assets	2,910,768	2,753,379
Total Assets	30,994,712	34,196,763
Current Liabilities:
Accounts payable	1,840,724	1,485,812
Current maturities of long-term debt	1,666,667	666,667
Lease liability – current portion	388,915	378,675
Accrued expenses and other current liabilities	2,815,025	4,385,720
Total current liabilities	6,711,331	6,916,874
Long term debt, net of current maturities and debt issuance costs	8,298,281	9,274,527
Lease liability, net of current portion	970,182	1,070,762
Total Liabilities	15,979,794	17,262,163
Commitments and Contingencies (Note 6)
Stockholders' Equity:
Preferred Stock, Par Value $0.001, 5,000,000 shares authorized; -0- shares issued and outstanding at March 31, 2019 and December 31, 2018	0	0
Common Stock, Par Value $0.001, 50,000,000 shares authorized; 32,243,044 and 31,774,139 shares issued and outstanding at March 31, 2019 and December 31, 2018, respectively	32,243	31,774
Additional paid-in capital	188,795,855	186,138,466
Accumulated other comprehensive income	594,462	288,175
Accumulated deficit	(174,407,642)	(169,523,815)
Total stockholders' equity	15,014,918	16,934,600
Total Liabilities and Stockholders' Equity	$ 30,994,712	$ 34,196,763

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($)	Mar. 31, 2019	Dec. 31, 2018
Allowance for doubtful accounts	$ 85,460	$ 83,726
Preferred Stock, Par value	$ 0.001	$ 0.001
Preferred Stock, Shares Authorized	5,000,000	5,000,000
Preferred Stock, Shares Issued	0	0
Preferred Stock, Shares Outstanding	0	0
Common Stock, Par Value	$ 0.001	$ 0.001
Common Stock, shares authorized	50,000,000	50,000,000
Common Stock, shares issued	32,243,044	31,774,139
Common Stock, shares outstanding	32,243,044	31,774,139

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS - USD ($)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Revenue:
CytoSorb sales	$ 4,509,779	$ 4,403,896
Other sales	66,800	29,400
Total product sales	4,576,579	4,433,296
Grant income	615,050	491,355
Total revenue	5,191,629	4,924,651
Cost of revenue	1,738,589	1,567,645
Gross margin	3,453,040	3,357,006
Other expenses:
Research and development	2,418,633	1,725,278
Legal, financial and other consulting	561,516	416,218
Selling, general and administrative	4,758,084	4,316,677
Total expenses	7,738,233	6,458,173
Loss from operations	(4,285,193)	(3,101,167)
Other income/(expense):
Interest expense, net	(205,179)	(239,098)
Gain (loss) on foreign currency transactions	(393,455)	358,230
Total other income, net	(598,634)	119,132
Loss before benefit from income taxes	(4,883,827)	(2,982,035)
Benefit from income taxes	0	0
Net loss available to common shareholders	$ (4,883,827)	$ (2,982,035)
Basic and diluted net loss per common share	$ (0.15)	$ (0.10)
Weighted average number of shares of common stock outstanding	31,931,215	29,351,174
Net loss	$ (4,883,827)	$ (2,982,035)
Other comprehensive income:
Currency translation adjustment	306,287	(329,912)
Comprehensive loss	$ (4,577,540)	$ (3,311,947)

CONSOLIDATED STATEMENT OF CHANG

CONSOLIDATED STATEMENT OF CHANGES IN STOCKHOLDERS' EQUITY - USD ($)	Total	Common Stock [Member]	Additional Paid-In Capital [Member]	Accumulated Other Comprehensive Income [Member]	Accumulated Deficit [Member]
Balance at Dec. 31, 2017	$ 10,262,835	$ 28,974	$ 162,907,482	$ (360,985)	$ (152,312,636)
Balance (in shares) at Dec. 31, 2017		28,973,679
Stock based compensation - employees, consultants and directors	524,449	$ 0	524,449	0	0
Issuance of common stock, net of fees	6,046,761	$ 782	6,045,979	0	0
Issuance of common stock, net of fees (in shares)		782,328
Other comprehensive income/(loss): foreign translation adjustment	(329,912)	$ 0	0	(329,912)	0
Proceeds from exercise of stock options	529,177	$ 132	529,045	0	0
Proceeds from exercise of stock options (in shares)		132,771
Cashless exercise of stock options	0	$ 26	(26)	0	0
Cashless exercise of stock options (in shares)		25,288
Cashless exercise of warrants	0	$ 8	(8)	0	0
Cashless exercise of warrants (in shares)		7,921
Issuance of restricted stock units	380,899	$ 48	380,851	0	0
Issuance of restricted stock units (in shares)		48,381
Proceeds from exercise of warrants	15,000	$ 4	14,996	0	0
Proceeds from exercise of warrants (in shares)		4,000
Net loss	(2,982,035)	$ 0	0	0	(2,982,035)
Balance at Mar. 31, 2018	14,447,174	$ 29,974	170,402,768	(690,897)	(155,294,671)
Balance (in shares) at Mar. 31, 2018		29,974,368
Balance at Dec. 31, 2017	10,262,835	$ 28,974	162,907,482	(360,985)	(152,312,636)
Balance (in shares) at Dec. 31, 2017		28,973,679
Balance at Dec. 31, 2018	16,934,600	$ 31,774	186,138,466	288,175	(169,523,815)
Balance (in shares) at Dec. 31, 2018		31,774,139
Stock based compensation - employees, consultants and directors	227,658	$ 0	227,658	0	0
Other comprehensive income/(loss): foreign translation adjustment	306,287	0	0	306,287	0
Proceeds from exercise of stock options	236,070	$ 47	236,023	0	0
Proceeds from exercise of stock options (in shares)		46,734
Cashless exercise of stock options	0	$ 0	0	0	0
Cashless exercise of stock options (in shares)		967
Cashless exercise of warrants	0	$ 9	(9)	0	0
Cashless exercise of warrants (in shares)		9,029
Issuance of restricted stock units	425,639	$ 52	425,587	0	0
Issuance of restricted stock units (in shares)		51,817
Proceeds from exercise of warrants	1,768,491	$ 361	1,768,130	0	0
Proceeds from exercise of warrants (in shares)		360,358
Net loss	(4,883,827)	$ 0	0	0	(4,883,827)
Balance at Mar. 31, 2019	$ 15,014,918	$ 32,243	$ 188,795,855	$ 594,462	$ (174,407,642)
Balance (in shares) at Mar. 31, 2019		32,243,044

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Cash flows from operating activities:
Net loss	$ (4,883,827)	$ (2,982,035)
Adjustments to reconcile net loss to net cash used in operating activities:
Non-cash compensation	261,747	217,220
Depreciation and amortization	138,175	56,574
Amortization of debt costs	23,754	25,787
Bad debt	14,193	4,057
Stock-based compensation	227,658	524,449
Foreign currency transaction loss (gain)	393,455	(358,230)
Changes in operating assets and liabilities:
Grants and accounts receivable	611,668	(117,527)
Inventories	(395,683)	114,700
Prepaid expenses and other current assets	435,423	38,623
Accounts payable and accrued expenses	(1,064,124)	272,604
Net cash used by operating activities	(4,237,561)	(2,203,778)
Cash flows from investing activities:
Purchases of property and equipment	(292,458)	(242,989)
Payments for patent costs	(181,769)	(229,287)
Net cash used by investing activities	(474,227)	(472,276)
Cash flows from financing activities:
Proceeds from long-term debt	0	666,667
Repayment of long-term debt	0	(666,667)
Payment of debt acquisition costs	0	(147,988)
Equity contributions - net of fees incurred	0	6,046,761
Proceeds from exercise of stock options	236,070	529,177
Proceeds from exercise of warrants	1,768,491	15,000
Net cash provided by financing activities	2,004,561	6,442,950
Effect of exchange rates on cash	(14,236)	990
Net change in cash and cash equivalents	(2,721,463)	3,767,886
Cash and cash equivalents - beginning of period	22,368,837	17,321,862
Cash and cash equivalents - end of period	19,647,374	21,089,748
Supplemental disclosure of cash flow information:
Cash paid during the period for interest	227,681	261,611
Supplemental disclosure of non-cash investing and financing activities:
Settlement of accrued bonuses with restricted stock units	$ 425,639	$ 380,899

BASIS OF PRESENTATION

BASIS OF PRESENTATION	3 Months Ended
	Mar. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
BASIS OF PRESENTATION	1. BASIS OF PRESENTATION The interim financial statements of CytoSorbents Corporation (the “Company”) have been prepared in conformity with accounting principles generally accepted in the United States of America (“U.S. GAAP”). In the opinion of management, the Company has made all necessary adjustments, which include normal recurring adjustments, for a fair statement of the Company’s financial position and results of operations for the interim periods presented. Certain information and disclosures normally included in the annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. These interim financial statements should be read in conjunction with the audited financial statements and accompanying notes for the year ended December 31, 2018 included in the Company’s Annual Report on Form 10-K, as filed with the Securities and Exchange Commission (the “SEC”) on March 7, 2019. The results for the three months ended March 31, 2019 and 2018 are not necessarily indicative of the results to be expected for a full year, any other interim periods or any future year or period. The accompanying consolidated financial statements have been prepared on a going concern basis, which contemplates the realization of assets and satisfaction of liabilities in the normal course of business. As of March 31, 2019, the Company had an accumulated deficit of $174,407,642, which included net losses of $4,883,827 for the three months ended March 31, 2019 and $2,982,035 for the three months ended March 31, 2018. The Company’s losses have resulted principally from costs incurred in the research and development of the Company’s polymer technology and selling, general and administrative expenses. The Company intends to continue to conduct significant additional research, development, and clinical study activities which, together with expenses incurred for the establishment of manufacturing arrangements and a marketing and distribution presence and other selling, general and administrative expenses, are expected to result in continuing net losses for the foreseeable future. The amount of future losses and when, if ever, the Company will achieve profitability are uncertain. The Company’s ability to achieve profitability will depend, among other things, on successfully completing the development of its technology and commercial products, obtaining additional requisite regulatory approvals in markets not covered by the CE mark previously received for the Company’s CytoSorb product and for potential label extensions of the current CE mark, establishing manufacturing and sales and marketing arrangements with third parties, and raising sufficient funds to finance the Company’s activities. No assurance can be given that the Company’s product development efforts will be successful, that the Company’s current CE mark will enable it to achieve profitability, that additional regulatory approvals in other countries will be obtained, that any of the Company’s products will be manufactured at a competitive cost and will be of acceptable quality, or that the Company will be able to achieve profitability or that profitability, if achieved, can be sustained. These matters raise substantial doubt about the Company’s ability to continue as a going concern. These consolidated financial statements do not include any adjustments related to the outcome of this uncertainty.

PRINCIPAL BUSINESS ACTIVITY AND

PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	3 Months Ended
	Mar. 31, 2019
Accounting Policies [Abstract]
PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	2. PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Nature of Business The Company is a leader in critical care immunotherapy using blood purification technology to treat deadly inflammation in critically-ill and cardiac surgery patients around the world. The Company, through its subsidiary CytoSorbents Medical, Inc. (formerly known as CytoSorbents, Inc.), is engaged in the research, development and commercialization of medical devices with its blood purification technology platform which incorporates a proprietary adsorbent, porous polymer technology. The Company, through its wholly owned European subsidiary, CytoSorbents Europe GmbH, conducts sales and marketing related operations for the Company’s flagship product, CytoSorb. In March 2016, the Company formed CytoSorbents Switzerland GmbH, a wholly-owned subsidiary of CytoSorbents Europe GmbH. This subsidiary, which began operations during the second quarter of 2016, provides marketing and direct sales services in Switzerland. In November 2018, the Company formed CytoSorbents Poland Sp. z.o.o., a wholly-owned subsidiary of CytoSorbents Europe GmbH. This subsidiary, which began operations during the first quarter of 2019, provides marketing and direct sales services in Poland. CytoSorb was approved in the European Union (“EU”) in March 2011, and is currently being marketed in and distributed in fifty-five countries around the world, as a safe and effective extracorporeal cytokine absorber, designed to reduce the “cytokine storm” that could otherwise cause massive inflammation, organ failure and death in common critical illnesses such as sepsis, burn injury, trauma, lung injury, and pancreatitis. In May 2018, the Company received a label extension for CytoSorb covering use of the device for the removal of bilirubin and myoglobin which allows for the use of the device in the treatment of liver failure and trauma, respectively. CytoSorb is also being used during and after cardiac surgery to remove inflammatory mediators, such as cytokines and free hemoglobin, which can lead to post-operative complications, including multiple organ failure. The technology is based upon biocompatible, highly porous polymer sorbent beads that can actively remove toxic substances from blood and other bodily fluids by pore capture and surface absorption. The Company has numerous products under development based upon this unique blood purification technology, which is protected by 19 issued U.S. patents and multiple international patents, with applications pending both in the U.S. and internationally, including HemoDefend, ContrastSorb, DrugSorb, and others. These patents and patent applications are directed to various compositions and methods of use related to our blood purification technologies and are expected to expire between 2020 and 2035, absent any patent term extensions. Management believes that any near term expiring patents will not have a significant impact on our ongoing business. Stock Market Listing On December 17, 2014 the Company’s common stock, par value $0.001 per share, was approved for listing on the Nasdaq Capital Market (“Nasdaq”), and it began trading on Nasdaq on December 23, 2014 under the symbol “CTSO.” Previously, the Company’s common stock traded in the over-the-counter-market on the OTC Bulletin Board. Basis of Consolidation and Foreign Currency Translation The consolidated financial statements include the accounts of CytoSorbents Corporation and its wholly-owned subsidiaries, CytoSorbents Medical, Inc. and CytoSorbents Europe GmbH. In addition, the financial statements include CytoSorbents Switzerland GmbH and CytoSorbents Poland Sp. z.o.o., wholly owned subsidiaries of CytoSorbents Europe GmbH. All significant intercompany transactions and balances have been eliminated in consolidation. Translation gains and losses resulting from the process of remeasuring into the United States Dollar, the foreign currency financial statements of CytoSorbents Europe GmbH, for which the Euro is the functional currency, are included in operations. Foreign currency transaction gain (loss) included in net loss amounted to approximately $(393,000) and $358,000 for the three months ended March 31, 2019 and 2018, respectively. The Company translates assets and liabilities of CytoSorbents Europe GmbH at the exchange rate in effect at the balance sheet date. The Company translates revenue and expenses at the daily average exchange rates. The Company includes accumulated net translation adjustments in accumulated other comprehensive income (loss) as a component of stockholders’ equity. Cash and Cash Equivalents The Company considers all highly liquid investments purchased with an original maturity of three months or less to be cash equivalents. Grants and Accounts Receivable Grants receivable represent amounts due from U.S. government agencies and are included in Grants and Accounts Receivable. Accounts receivable are unsecured, non-interest bearing customer obligations due under normal trade terms. The Company sells its devices to various hospitals and distributors. The Company performs ongoing credit evaluations of its customers’ financial conditions. Management reviews accounts receivable periodically to determine collectability. Balances that are determined to be uncollectible are written off to the allowance for doubtful accounts. The allowance for doubtful accounts contains a general accrual for estimated bad debts and amounted to approximately $85,000 and $84,000 at March 31, 2019 and December 31, 2018, respectively. Inventories Inventories are valued at the lower of cost or net realizable value under the first in, first out (FIFO) method. At March 31, 2019 and December 31, 2018, the Company’s inventory was comprised of finished goods, which amounted to $382,651 and $213,839, respectively; work in process which amounted to $572,937 and $415,265, respectively; and raw materials, which amounted to $258,018 and $204,029, respectively. Devices used in clinical trials or for research and development purposes are removed from inventory and charged to research and development expenses at the time of their use. Property and Equipment Property and equipment are recorded at cost less accumulated depreciation. Depreciation of property and equipment is provided for by the straight-line method over the estimated useful lives of the related assets. Leasehold improvements are amortized over the lesser of their economic useful lives or the term of the related leases. Gains and losses on depreciable assets retired or sold are recognized in the statements of operations in the year of disposal. Repairs and maintenance expenditures are expensed as incurred. Patents Legal costs incurred to establish and successfully defend patents are capitalized. When patents are issued, capitalized costs are amortized on the straight-line method over the related patent term. In the event a patent is abandoned, the net book value of the patent is written off. Impairment or Disposal of Long-Lived Assets The Company assesses the impairment of patents and other long-lived assets under accounting standards for the impairment or disposal of long-lived assets whenever events or changes in circumstances indicate that the carrying value may not be recoverable. For long-lived assets to be held and used, the Company recognizes an impairment loss only if its carrying amount is not recoverable through its undiscounted cash flows and measures the impairment loss based on the difference between the carrying amount and fair value. Revenue Recognition Product Sales : Revenues from sales of products to both direct and distributor/strategic partner customers are recognized at the time when control passes to the customer, in accordance with the terms of their respective contracts. Recognition of revenue occurs as each performance obligation is completed. Grant Income : Revenue from grant income is based on contractual agreements. Certain agreements provide for reimbursement of costs, while other agreements provide for reimbursement of costs and an overhead margin. Revenues are recognized when the associated performance obligation is fulfilled. Costs are recorded as incurred. Costs subject to reimbursement by these grants have been reflected as costs of revenue. Research and Development All research and development costs, payments to laboratories and research consultants are expensed when incurred. Advertising Expenses Advertising expenses are charged to activities when incurred. Advertising expenses amounted to approximately $51,800 and $36,762 for the three months ended March 31, 2019 and 2018, respectively, and are included in selling, general, and administrative expenses on the consolidated statement of operations. Income Taxes Income taxes are accounted for under the asset and liability method prescribed by accounting standards for accounting for income taxes. Deferred income taxes are recorded for temporary differences between financial statement carrying amounts and the tax basis of assets and liabilities. Deferred tax assets and liabilities reflect the tax rates expected to be in effect for the years in which the differences are expected to reverse. A valuation allowance is provided if it is more likely than not that some or all of the deferred tax asset will not be realized. The Company has provided a valuation allowance against all deferred tax assets. Under Section 382 of the Internal Revenue Code, the net operating losses generated prior to the previously completed reverse merger may be limited due to the change in ownership. Additionally, net operating losses generated subsequent to the reverse merger may be limited in the event of changes in ownership. The Company follows accounting standards associated with uncertain tax positions. The Company had no unrecognized tax benefits at March 31, 2019 or December 31, 2018. The Company files tax returns in the U.S. federal and state jurisdictions. The Company utilizes the Technology Business Tax Certificate Transfer Program to sell a portion of its New Jersey Net Operating Loss carry forwards to an industrial company. Each of CytoSorbents Europe GmbH, CytoSorbents Switzerland GmbH and CytoSorbents Poland Sp. Z.o.o. file an annual corporate tax return, VAT return and a trade tax return in Germany, Switzerland and Poland, respectively. Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities. Actual results could differ from these estimates. Significant estimates in these financials are the valuation of options granted, and valuation methods used to determine the change in fair value of the down round feature related to certain of the Company’s outstanding warrants. Concentration of Credit Risk The Company maintains cash balances, at times, with financial institutions in excess of amounts insured by the Federal Deposit Insurance Corporation. Management monitors the soundness of these institutions in an effort to minimize its collection risk of these balances. A significant portion of our revenues are from product sales in Germany. Substantially all of our grant and other income are from grant agencies in the United States. (See Note 4 for further information relating to the Company’s revenue.) As of March 31, 2019, one distributor accounted for approximately 20% of outstanding grants and accounts receivable. As of March 31, 2018, one distributor accounted for approximately 11% of outstanding grants and accounts receivable. As of December 31, 2018, two distributors/strategic partners accounted for approximately 29% of the outstanding grants and accounts receivable. For the three months ended March 31, 2019 and 2018, no agency, distributor, or direct customer represented more than 10% of the Company’s total revenue. Financial Instruments The carrying values of cash and cash equivalents, short-term investments, accounts payable, notes payable, and other debt obligations approximate their fair values due to their short-term nature. Net Loss Per Common Share Basic earnings per share is computed by dividing loss available to common stockholders by the weighted average number of common shares outstanding during the period. Diluted earnings per common share is computed using the treasury stock method on the basis of the weighted-average number of shares of common stock plus the dilutive effect of potential common shares outstanding during the period. Dilutive potential common shares include outstanding warrants, stock options and restricted shares. The computation of diluted earnings per share does not assume conversion, exercise or contingent exercise of securities that would have an anti-dilutive effect on earnings (See Note 8). Stock-Based Compensation The Company accounts for its stock-based compensation under the recognition requirements of accounting standards for accounting for stock-based compensation, for employees and directors whereby each option granted is valued at fair market value on the date of grant. Under these accounting standards, the fair value of each option is estimated on the date of grant using the Black-Scholes option pricing model. The Company also follows the guidance of accounting standards for accounting for equity instruments that are issued to other than employees for acquiring, or in conjunction with selling, goods or services for equity instruments issued to consultants. Effects of Recent Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, “Leases (Topic 842)”. ASU 2016-02 outlines reporting requirements for lessees to recognize a right-of-use asset and corresponding liability on the balance sheet for all leases covering a period of greater than 12 months. The liability is to be measured as the present value of the future minimum lease payments, plus any initial direct costs. The minimum payments are discounted using the rate implicit in the lease, or, if not known, the lessee’s incremental borrowing rate. The updated guidance is effective for public entities for fiscal years beginning after December 31, 2018. The Company has adopted the updated guidance effective January 1, 2019. See Note 7 for details regarding the Company’s leases. Shipping and Handling Costs The cost of shipping product to customers and distributors is typically borne by the customer or distributor. The Company records other shipping and handling costs in cost of revenue. Total freight costs amounted to approximately $146,500 and $135,800, respectively, for the three months ended March 31, 2019 and 2018. Reclassifications Certain reclassifications have been made to the March 31, 2018 financial statements in order to conform to the 2019 financial statement presentation. There was no change in the reported amount of the accumulated deficit as a result of these reclassifications.

STOCKHOLDERS' EQUITY

STOCKHOLDERS' EQUITY	3 Months Ended
	Mar. 31, 2019
Stockholders' Equity Note [Abstract]
STOCKHOLDERS' EQUITY	3. STOCKHOLDERS' EQUITY Preferred Stock In December 2014, the Company amended and restated its certificate of incorporation to reduce the total number of authorized shares of preferred stock. The amended and restated certificate of incorporation authorizes the issuance of up to 5,000,000 shares of “blank check” preferred stock, with such designation rights and preferences as may be determined from time to time by the Board of Directors. Common Stock Shelf Registration On July 29, 2015, the Company’s registration statement on Form S-3, as filed with the SEC on July 23, 2015 (the “2015 Shelf”), was declared effective using a “shelf” registration process. On July 26, 2018, in anticipation of the expiration of the 2015 Shelf, the Company filed a new registration statement on Form S-3 with the SEC (as amended, the “2018 Shelf”). The 2018 Shelf, which was declared effective on August 7, 2018, enables the Company to offer and sell, in one or more offerings, any combination of common stock, preferred stock, senior or subordinated debt securities, warrants and units, up to a total dollar amount of $150 million. Controlled Equity Offering SM On November 4, 2015, the Company entered into a Controlled Equity Offering SM On July 26, 2018, the Company entered into that certain Amendment No. 1 to the Sales Agreement (the “Sales Agreement Amendment”) to extend the term of the Sales Agreement until the expiration of the 2018 Shelf. The other provisions of the Sales Agreement remain unchanged. References herein to “Sales Agreement” shall refer to the Sales Agreement, as amended by the Sales Agreement Amendment. Under the Sales Agreement, Cantor may sell Shares by any method permitted by law and deemed to be an “at the market offering” as defined in Rule 415 promulgated under the Securities Act, including sales made directly on Nasdaq, on any existing trading market for the common stock or to or through a market maker. In addition, under the Sales Agreement, Cantor may sell the Shares by any other method permitted by law, including in privately negotiated transactions. The Company may instruct Cantor not to sell Shares if the sales cannot be effected at or above the price designated by the Company from time to time. The Company is not obligated to make any sales of Shares under the Sales Agreement, and if it elects to make any sales, the Company can set a minimum sales price for the Shares. The offering of Shares pursuant to the Sales Agreement will terminate upon the earlier of (a) the expiration of the 2018 Shelf or (b) the termination of the Sales Agreement by Cantor or the Company, as permitted therein. From November 4, 2015 through December 31, 2015, the Company sold 28,880 shares, generating net proceeds of approximately $225,000 under the Sales Agreement. There were no sales during the year ended December 31, 2016. During the year ended December 31, 2017, the Company sold 550,000 shares at an average price of $6.31 per share, generating net proceeds of approximately $3,367,000. During the year ended December 31, 2018, the Company sold 1,515,260 shares at an average cost of $9.61 per share, generating net proceeds of approximately $14,127,000. There were no sales during the three months ended March 31, 2019. In the aggregate, the Company has sold 2,094,140 shares at an average selling price of $8.72 per share, generating net proceeds of approximately $17,718,000 under the terms of the Sales Agreement. The Company pays a commission rate of 3.0% of the aggregate gross proceeds from each sale of Shares and has agreed to provide Cantor with customary indemnification and contribution rights. In 2015, the Company reimbursed Cantor $50,000 for certain specified expenses in connection with the execution of the Sales Agreement. The Company intends to use the net proceeds raised through “at the market” sales to fund clinical studies in the United States and abroad, expand production capacity, support its sales and marketing efforts, further develop its products, and for general working capital purposes. Stock-Based Compensation Total share-based employee, director, and consultant compensation for the three months ended March 31, 2019 and 2018 amounted to approximately $228,000 and $524,000, respectively. These amounts are included in the statement of operations under general and administrative expenses. The summary of the stock option activity for the three months ended March 31, 2019 is as follows: Weighted Weighted Average Average Remaining Exercise Price Contractual Shares per Share Life (Years) Outstanding, December 31, 2018 3,658,462 $ 5.82 7.0 Granted 60,800 $ 6.99 9.3 Forfeited (34,817 ) $ 7.56 — Expired (4,000 ) $ 4.20 — Exercised (55,642 ) $ 4.58 — Outstanding, March 31, 2019 3,624,803 $ 5.86 6.8 The fair value of each stock option was estimated using the Black Scholes pricing model which takes into account as of the grant date the exercise price (ranging from $6.98 to $8.10 per share) and expected life of the stock option (10 years), the current price of the underlying stock and its expected volatility (61.9 percent), expected dividends (-0- percent) on the stock and the risk free interest rate (ranging from 2.24 to 2.61 percent) for the term of the stock option. The intrinsic value is calculated at the difference between the market value as of March 31, 2019 of $7.57 and the exercise price of the shares. Options Outstanding Number Weighted Weighted Range of Outstanding at Average Average Aggregate Exercise March 31, Exercise Remaining Intrinsic Price 2019 Price Life (Years) Value $2.23 - $14.80 3,624,803 $ 5.86 6.8 $ 6,899,653 Options Exercisable Number Weighted Exercisable at Average Aggregate March 31, Exercise Intrinsic 2019 Price Value 2,845,173 $ 5.36 $ 6,486,837 The summary of the status of the Company’s non-vested options for the three months ended March 31, 2019 is as follows: Weighted Average Grant Date Shares Fair Value Non-vested, December 31, 2018 1,251,617 $ 4.56 Granted 60,800 $ 4.00 Forfeited (34,817 ) $ 4.57 Vested (497,970 ) $ 6.90 Non-vested, March 31, 2019 779,630 $ 4.65 As of March 31, 2019, the Company had approximately $800,000 of total unrecognized compensation cost related to stock options which will be amortized over six months. Change in Control-Based Awards of Restricted Stock Units: The Board of Directors has granted restricted stock units to members of the Board of Directors, to the Company’s executive officers, and to employees of the Company. These restricted stock units will only vest upon a Change in Control of the Company, as defined in the Company’s 2014 Long-Term Incentive Plan. The following table is a summary of these restricted stock units: Restricted Stock Units Board of Executive Other Directors Management Employees Total Intrinsic Value December 31, 2018 277,200 724,500 1,002,300 2,004,000 $ 16,192,320 Granted - - - - Forfeited - - (6,000 ) (6,000 ) March 31, 2019 277,200 724,500 996,300 1,998,000 $ 15,124,860 Due to the uncertainty over whether these restricted stock units will vest, which only happens upon a Change in Control, no charge for these restricted stock units has been recorded in the consolidated statement of operations for the three months ended March 31, 2019 and 2018. Performance-Based Awards of Restricted Stock Units: Pursuant to a review of the compensation of the senior management of the Company and managements’ performance in 2016, on February 24, 2017, the Board of Directors granted 125,000 restricted stock units to certain senior managers of the Company in order to settle bonuses accrued as of December 31, 2016. These awards were valued at approximately $700,000 at the date of issuance, based upon the market price of the Company’s common stock at the date of the grant, and vest one third on the date of the grant, one third on the first anniversary of the date of the grant, and one third on the second anniversary of the date of the grant. For the three months ended March 31, 2019 and 2018, the Company recorded a charge of approximately $150,000 and $154,000, respectively, related to these restricted stock unit awards. Pursuant to a review of the compensation of the senior management of the Company and managements’ performance in 2017, on February 28, 2018, the Board of Directors granted 146,200 restricted stock units to certain senior managers of the Company in order to settle bonuses accrued as of December 31, 2017. These awards were valued at approximately $1,148,000 at the date of issuance, based upon the market price of the Company’s common stock at the date of the grant, and vest one third on the date of the grant one third on the first anniversary of the date of the grant, and one third on the second anniversary of the date of the grant. For the three months ended March 31, 2019 and 2018, the Company recorded a charge of approximately $107,000 and $32,000, respectively, related to these restricted stock unit awards. Pursuant to a review of the compensation of the senior management of the Company and managements’ performance in 2018, on March 4, 2019 the Board of Directors granted 22,220 restricted stock units to certain senior managers of the Company in order to settle bonuses accrued as of December 31, 2018. These awards were valued at approximately $179,000 at the date of issuance, based upon the market price of the Company’s common stock at the date of the grant, and vest one third on the date of the grant one third on the first anniversary of the date of the grant, and one third on the second anniversary of the date of the grant. For the three months ended March 31, 2019 and 2018, the Company recorded a charge of approximately $5,000 and $0 respectively, related to these restricted stock unit awards. The following table outlines the restricted stock unit activity for the three months ended March 31, 2019: Weighted Average Grant Date Shares Fair Value Non-vested, January 1, 2019 139,138 $ 7.18 Granted 22,220 $ 8.05 Vested (97,806 ) $ 6.63 Non-vested, March 31, 2019 63,552 $ 7.90 Warrants: As of March 31, 2019, the Company has 30,000 warrants to purchase common stock outstanding. These warrants have an exercise price of $9.90 and expire on January 14, 2020.

REVENUE

REVENUE	3 Months Ended
	Mar. 31, 2019
Revenue from Contract with Customer [Abstract]
REVENUE	4. REVENUE The following table disaggregates the Company’s revenue by customer type and geographic area for the three months ended March 31, 2019: United States Distributors/ Government Direct Strategic Partners Agencies Total Product sales: United States $ 66,800 $ – $ – $ 66,800 Germany 3,098,176 – – 3,098,176 All other countries 816,229 595,374 – 1,411,603 Total product revenue 3,981,205 595,374 – 4,576,579 Grant and other income: United States – – 615,050 615,050 Total revenue $ 3,981,205 $ 595,374 $ 615,050 $ 5,191,629 The following table disaggregates the Company’s revenue by customer type and geographic area for the three months ended March 31, 2018: United States Distributors/ Government Direct Strategic Partners Agencies Total Product sales: United States $ 1,800 $ – $ – $ 1,800 Germany 2,667,408 – – 2,667,408 All other countries 693,404 1,070,684 – 1,764,088 Total product revenue 3,362,612 1,070,684 – 4,433,296 Grant and other income: United States – – 491,355 491,355 Total revenue $ 3,362,612 $ 1,070,684 $ 491,355 $ 4,924,651 The Company has two primary revenue streams: (1) sales of the CytoSorb device and related device accessories and (2) grant income from contracts with various agencies of the United States government. Both of these revenue streams are within the scope of this accounting pronouncement. The following is a brief description of each revenue stream. CytoSorb Sales The Company sells its CytoSorb device using both its own sales force (direct sales) and through the use of distributors and/or strategic partners. All sales of the device are outside the United States, as CytoSorb is not yet approved in the United States. Direct sales are fulfilled from the Company’s office in Berlin, Germany. Direct sales relate to sales to hospitals located in Germany, Switzerland, Austria, Belgium, Luxembourg, Poland, the Netherlands, Sweden, Denmark and Norway. There are no formal sales contracts with any direct customers relating to product price or minimum purchase requirements. However, there are agreements in place with certain direct customers that provide for either free of charge product or rebate credits based upon achieving minimum purchase levels. The Company records the value of these items as earned as a reduction of revenue. These customers submit purchase orders and the order is fulfilled and shipped directly to the customer. Prices to all direct customers are based on a standard price list based on the packaged quantity (6 packs vs 12 packs). Distributor and strategic partner sales make up the remaining product sales. These distributors are located in various countries throughout the world. The Company has a formal written contract with each distributor/strategic partner. These contracts have terms ranging from 1-5 years in length, with three years being the typical term. In addition, certain distributors are eligible for volume discount pricing if their unit sales are in excess of the base amount in the contract. Government Grants The Company has been the recipient of various grant contracts from various agencies of the United States government, primarily the Department of Defense, to perform various research and development activities. These contacts fall into one of the following categories: 1. Fixed price – the Company invoices the contract amount in equal installments over the term of the contract without regard to the timing of the costs incurred related to this contract. 2. Cost reimbursement – the Company submits monthly invoices during the term of the contract for the amount of direct costs incurred during that month plus an agreed percentage that relates to allowable overhead and general and administrative expenses. Cumulative amounts invoiced may not exceed the maximum amount of funding stipulated in the contract. 3. Cost plus – this type of contract is similar to a cost reimbursement contract but this type also allows for the Company to additionally invoice for a fee amount that is included in the contract. In summary, the contracts the Company has with customers are the distributor/strategic partner contracts related to CytoSorb product sales, agreements with direct customers related to free-of-charge product and credit rebates based upon achieving minimum purchase levels, and contracts with various government agencies related to the Company’s grants. The Company does not currently incur any outside/third party incremental costs to obtain any of these contracts. The Company does incur internal costs, primarily salary related costs, to obtain the contracts related to the grants. Company employees spend time reviewing the program requirements and developing the budget and related proposal to submit to the grantor agency. There may additionally be travel expenditures involved with meeting with government agency officials during the negotiation of the contract. These internal costs are expensed as incurred. The following table provides information about receivables and contract liabilities from contracts with customers: March 31, 2019 December 31, 2018 Receivables, which are included in grants and accounts receivable $ 1,950,155 $ 2,399,662 Contract liabilities $ 10,462 $ 42,219 Contract liabilities represent the value of free of charge goods and credit rebates earned in accordance with the terms of certain direct customer agreements during the periods ended March 31, 2019 and December 31, 2018, and deferred revenue on distributor/strategic partner contracts. Deferred revenue is the difference between the average selling price anticipated for the year ended 2019 and the actual price invoiced during the three months ended March 31, 2019. There was no deferred revenue liability as of December 31, 2018.

LONG-TERM DEBT, NET

LONG-TERM DEBT, NET	3 Months Ended
	Mar. 31, 2019
Debt Disclosure [Abstract]
LONG-TERM DEBT, NET	5. LONG-TERM DEBT, NET On June 30, 2016, the Company and its wholly-owned subsidiary, CytoSorbents Medical, Inc. (together, the “Borrower”), entered into a Loan and Security Agreement with Bridge Bank, a division of Western Alliance Bank, (the “Bank”), pursuant to which the Company borrowed $10 million in two equal tranches of $5 million (the “Original Term Loans”). On March 29, 2018 (the “Closing Date”), the Original Term Loans were refinanced with the Bank pursuant to an Amended and Restated Loan and Security Agreement by and between the Bank and the Borrower (the “Amended and Restated Loan and Security Agreement”), under which the Bank agreed to loan the Borrower up to an aggregate of $15 million to be disbursed in two tranches (1) one tranche of $10 million (the “Term A Loan”), which was funded on the Closing Date and used to refinance the Original Term Loans, and (2) a second tranche of $5 million which may be disbursed at the Borrower’s sole request prior to March 31, 2019 provided certain conditions are met (the “Term B Loan” and together with the Term A Loan, the “Term Loans”). In March 2019, the Borrower declined to receive the Term B loan. The proceeds of Term A Loan were used for general business requirements in accordance with the Amended and Restated Loan and Security Agreement. The outstanding balance on Term A Loan bears interest at the prime rate reported in the Wall Street Journal plus 3.66%. This rate was 9.16% at March 31, 2019. On the Closing Date, the Company was required to pay a non-refundable closing fee of $25,000, expenses incurred by the Bank related to the Amended and Restated Loan and Security Agreement of $11,000 and a portion of the final fee for the period the Original Term Loans were outstanding of $85,938. In addition, the Company incurred legal expenses related to the Amended and Restated Loan and Security Agreement of $20,050. As of the Closing Date, the total unamortized loan costs related to the Term Loans amounted to $130,060. These costs have been presented as a direct deduction from the proceeds of the loan on the consolidated balance sheet in accordance with the provisions of ASC 850. These costs are being amortized over the loan period as a charge to interest expense. For the three months ended March 31, 2019 and 2018, the Company recorded interest expense amounting to $8,129 and $7,558, respectively, related to these costs. After accounting for the various costs outlined above, the effective interest rate on the Term A Loan was 9.1% as of March 29, 2018. Commencing on the first calendar day of the calendar month after Term A Loan was made, the Company was required to make monthly payments of interest only. Commencing on November 1, 2019, the Company shall make equal monthly payments of principal of $333,333, together with accrued and unpaid interest. All unpaid principal and accrued and unpaid interest shall be due and payable in full on April 1, 2022. In addition, the Amended and Restated Loan and Security Agreement requires the Company to pay a non-refundable final fee equal to 2.5% of the principal amount of each Term Loan funded upon the earlier of the (i) April 1, 2022 maturity date or (ii) termination of the Term Loan via acceleration or prepayment. This final fee is being accrued and charged to interest expense over the term of the loan. For the three months ended March 31, 2019 and 2018, the Company recorded interest expense of $15,625 and $18,229, respectively, related to the final fee. The Term Loan is evidenced by a secured promissory note issued to the Bank by the Company. If the Company elects to prepay the Term Loan pursuant to the terms of the Amended and Restated Loan and Security Agreement, it will owe a prepayment fee to the Bank, as follows: (1) for a prepayment made on or after the funding date of a Term Loan through and including the first anniversary of such funding date, an amount equal to 2.0% of the principal amount of such Term Loan prepaid; (2) for a prepayment made after the first anniversary of the funding date of a Term Loan through and including the second anniversary of such funding date, an amount equal to 1.5% of the principal amount of such Term Loan prepaid; and (3) for a prepayment made after the second anniversary of the funding date of a Term Loan through April 1, 2022, an amount equal to 1.0% of the principal amount of such Term Loan prepaid. Events of default which may cause repayment of the Term Loans to be accelerated include, among other customary events of default, (1) non-payment of any obligation when due, (2) the failure to perform any obligation required under the Amended and Restated Loan and Security Agreement and to cure such default within a reasonable time frame, (3) the occurrence of a Material Adverse Event (as defined in the Amended and Restated Loan and Security Agreement), (4) the attachment or seizure of a material portion of the Borrower’s assets if such attachment or seizure is not released, discharged or rescinded within 10 days, and (5) if the Borrower becomes insolvent or starts an insolvency proceeding or if an insolvency proceeding is brought by a third party against the Borrower and such proceeding is not dismissed or stayed within 30 days. The Amended and Restated Loan and Security Agreement includes customary loan conditions, Borrower representations and warranties, Borrower affirmative covenants and Borrower negative covenants for secured transactions of this type. The Company is in substantial compliance with these covenants. The Company’s and CytoSorbents Medical, Inc.’s obligations under the Amended and Restated Loan and Security Agreement are joint and severable and are secured by a first priority security interest in favor of the Bank with respect to the Company’s Shares (as defined in the Amended and Restated Loan and Security Agreement) and the Borrower’s Collateral (as defined in the Amended and Restated Loan and Security Agreement, which definition excludes the Borrower’s intellectual property and other customary exceptions). Success Fee Letter: Pursuant to that certain Success Fee Letter (the “2016 Letter”) entered into between the Borrower and the Bank in connection with the Original Term Loans, the Borrower agreed to pay to the Bank a success fee in the amount equal to 6.37% of the funded amount of the Original Term Loans (the “2016 Letter Success Fee”) upon the first occurrence of any of the following events: (a) a sale or other disposition by the Borrower of all or substantially all of its assets; (b) a merger or consolidation of the Borrower into or with another person or entity, where the holders of the Borrower’s outstanding voting equity securities as of immediately prior to such merger or consolidation hold less than a majority of the issued and outstanding voting equity securities of the successor or surviving person or entity as of immediately following the consummation of such merger or consolidation; (c) a transaction or a series of related transactions in which any “person” or “group” (within the meaning of Section 13(d) and 14(d)(2) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”) becomes the “beneficial owner” (as defined in Rule 13d-3 under the Exchange Act), directly or indirectly, of a sufficient number of shares of all classes of stock then outstanding of the Borrower ordinarily entitled to vote in the election of directors, empowering such “person” or “group” to elect a majority of the Board of Directors of the Borrower, who did not have such power before such transaction; or (d) the closing price per share for the Company’s common stock on Nasdaq being $8.00 (after giving effect to any stock splits or consolidations effected after the date thereof) or more for five successive business days. On May 18, 2018, the 2016 Letter Success Fee became due to the Bank as result of an occurrence of the event described in clause (d) above. The Company elected to satisfy the 2016 Letter Success Fee by issuing shares of its common stock, which was permitted under the terms of the 2016 Letter. On May 23, 2018, the Company issued 68,791 shares of its common stock in full satisfaction of the 2016 Letter Success Fee, and the obligations of the Borrower under the 2016 Letter. The 2016 Letter Success Fee was valued at $637,000 and was charged to interest expense. Long-term debt consists of the following at March 31, 2019: Principal amount $ 10,000,000 Less unamortized debt acquisition costs (97,552 ) Plus accrued final fee 62,500 Subtotal 9,964,948 Less Current maturities (1,666,667 ) Long-term debt net of current maturities $ 8,298,281 Required principal payments of long-term debt for the twelve months ended March 31, are as follows: 2020 $ 1,666,667 2021 4,000,000 2022 4,000,000 2023 333,333 Total $ 10,000,000

COMMITMENTS AND CONTINGENCIES

COMMITMENTS AND CONTINGENCIES	3 Months Ended
	Mar. 31, 2019
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	6. COMMITMENTS AND CONTINGENCIES Employment Agreements On July 14, 2015, CytoSorbents Corporation entered into executive employment agreements with its principal executives, Dr. Phillip P. Chan, President and Chief Executive Officer, Vincent Capponi, Chief Operating Officer, and Kathleen P. Bloch, Chief Financial Officer. Each of the agreements has an initial term of three years, and was retroactively effective as of January 1, 2015. After 2017, the employment agreements automatically renewed for an additional term of one year. Accordingly, the employment agreements expired on December 31, 2018. The Company is currently negotiating new employment agreements with Dr. Chan, Mr. Capponi, and Ms. Bloch. The parties continue to operate under the terms of the expired agreements as they negotiate the new agreements. On May 30, 2017, CytoSorbents Corporation announced the appointment of Dr. Eric R. Mortensen as the Company’s Chief Medical Officer, pursuant to the terms of an employment agreement dated May 23, 2017. Dr. Mortensen’s employment agreement provides for an initial term commencing on June 1, 2017 and ending on December 31, 2019. The foregoing employment agreements each provide for base salary and other customary benefits which include participation in group insurance plans, paid time off and reimbursement of certain business related expenses, including travel and continuing educational expenses, as well as bonus and/or equity awards at the discretion of the Board of Directors. In addition, the agreements provide for certain termination benefits in the event of termination without “Cause” or voluntary termination of employment for “Good Reason”, as defined in each agreement. The agreements also provide for certain benefits in the event of a “Change of Control” of the Company, as defined in each agreement. Litigation The Company is from time to time subject to claims and litigation arising out of the ordinary course of business. The Company intends to defend vigorously against any future claims and litigation. The Company is not currently a party to any legal proceedings. Royalty Agreements Pursuant to an agreement dated August 11, 2003, an existing investor agreed to make a $4 million equity investment in the Company. These amounts were received by the Company in 2003. In connection with this agreement, the Company granted the investor a future royalty of 3% on all gross revenues received by the Company from the sale of its CytoSorb device. For the three months ended March 31, 2019 and 2018, the Company has recorded royalty costs of approximately $134,000 and $131,000, respectively. License Agreements In March 2006, the Company entered into a license agreement which provides the Company the exclusive right to use its patented technology and proprietary know how relating to adsorbent polymers for a period of 18 years. Under the terms of the agreement, the Company has agreed to pay royalties of 2.5% to 5% on the sale of certain of its products if and when those products are sold commercially for a term not greater than 18 years commencing with the first sale of such product. For the three months ended March 31, 2019 and 2018, per the terms of the license agreement, the Company has recorded royalty costs of approximately $224,000 and $219,000, respectively.

LEASES

LEASES	3 Months Ended
	Mar. 31, 2019
Leases, Operating [Abstract]
LEASES	7. LEASES Effective January 1, 2019, the Company adopted the provisions of Accounting Standards Update (“ASU”) 2016-02, Leases (Topic 842). The provisions of this ASU require the Company to record a right-of-use asset and related lease liability related to their leases. Accordingly, the Company has adjusted its December 31, 2018 balance sheet to properly reflect the provisions of this ASU as discussed below. Description of Leases: The Company leases its operating facilities in both the United States and Germany under operating lease agreements. In the United States, in January 2019, the Company entered into an Eighteenth Amendment to Lease with the landlord which became effective February 1, 2019. This amendment expands the Company’s space to 19,920 square feet and extends the term of the lease to May 31, 2020. The Company’s base rent is approximately $32,000 per month. In addition, the Company is obligated to pay monthly operating expenses of approximately $29,000 per month. The amendment also includes a one year renewal option. The base rent for the renewal term will increase by the greater of five percent or the increase in the Consumer Price Index. There were no lease incentives and no initial direct costs were incurred related to this lease amendment. In Germany, the Company leases its operating facility under two operating lease agreements. These leases require combined base rent payments amounting to approximately $8,800 per month. The initial lease term of both leases ends August 31, 2021. In addition, the Company is obligated to monthly operating expenses of approximately $2,900 per month. Both leases have a five year option to renew that would extend the lease term to August 31, 2026. There are no provisions in the leases to increase the base rent during the renewal period. There were no lease incentives and no initial direct costs were incurred related to these leases. Initial Measurement of Right-Of-Use Asset and Lease Liability: Under the provisions of this ASU, the Company has adjusted its balance sheet at December 31, 2018 to reflect the value of the right-of-use asset and related lease liability. This value was calculated based on the present value of the remaining base rent lease payments. The remaining lease payments include the renewal periods for both facilities as the Company has determined that it is probable that the renewal options will be exercised under each of the lease agreements. The discount rate used was the Company’s incremental borrowing rate, which is 9.16%, as the Company could not determine the rate implicit in the lease. As a result, the value of the right-of-asset and related lease liability is as follows: March 31, December 31, 2019 2018 Right-of-use asset $ 1,359,097 $ 1,449,437 Total lease liability $ 1,359,097 $ 1,449,437 Less current portion (388,915 ) (378,675 ) Lease liability, net of current portion $ 970,182 $ 1,070,762 The maturities of the lease liabilities are as follows as of March 31, 2019: 2020 $ 388,915 2021 442,865 2022 136,098 2023 75,308 2024 82,503 Thereafter 233,408 Total $ 1,359,097 For the three months ended March 31, 2019 and 2018, operating cash flows paid in connection with operating leases amounted to approximately $215,000 and $199,000, respectively. As of March 31, 2019 and December 31, 2018, the weighted average remaining lease term amount to 4.25 years and 4.50 years, respectively.

NET LOSS PER SHARE

NET LOSS PER SHARE	3 Months Ended
	Mar. 31, 2019
Earnings Per Share [Abstract]
NET LOSS PER SHARE	8. NET LOSS PER SHARE Basic loss per share and diluted loss per share for the three months ended March 31, 2019 and 2018 have been computed by dividing the net loss for each respective period by the weighted average number of shares outstanding during that period. All outstanding warrants and options and restricted stock awards representing approximately 5,716,000 and 6,848,000 incremental shares at March 31, 2019 and 2018 have been excluded from the computation of diluted loss per share as they are anti-dilutive.

PRINCIPAL BUSINESS ACTIVITY A_2

PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	3 Months Ended
	Mar. 31, 2019
Accounting Policies [Abstract]
Nature of Business	Nature of Business The Company is a leader in critical care immunotherapy using blood purification technology to treat deadly inflammation in critically-ill and cardiac surgery patients around the world. The Company, through its subsidiary CytoSorbents Medical, Inc. (formerly known as CytoSorbents, Inc.), is engaged in the research, development and commercialization of medical devices with its blood purification technology platform which incorporates a proprietary adsorbent, porous polymer technology. The Company, through its wholly owned European subsidiary, CytoSorbents Europe GmbH, conducts sales and marketing related operations for the Company’s flagship product, CytoSorb. In March 2016, the Company formed CytoSorbents Switzerland GmbH, a wholly-owned subsidiary of CytoSorbents Europe GmbH. This subsidiary, which began operations during the second quarter of 2016, provides marketing and direct sales services in Switzerland. In November 2018, the Company formed CytoSorbents Poland Sp. z.o.o., a wholly-owned subsidiary of CytoSorbents Europe GmbH. This subsidiary, which began operations during the first quarter of 2019, provides marketing and direct sales services in Poland. CytoSorb was approved in the European Union (“EU”) in March 2011, and is currently being marketed in and distributed in fifty-five countries around the world, as a safe and effective extracorporeal cytokine absorber, designed to reduce the “cytokine storm” that could otherwise cause massive inflammation, organ failure and death in common critical illnesses such as sepsis, burn injury, trauma, lung injury, and pancreatitis. In May 2018, the Company received a label extension for CytoSorb covering use of the device for the removal of bilirubin and myoglobin which allows for the use of the device in the treatment of liver failure and trauma, respectively. CytoSorb is also being used during and after cardiac surgery to remove inflammatory mediators, such as cytokines and free hemoglobin, which can lead to post-operative complications, including multiple organ failure. The technology is based upon biocompatible, highly porous polymer sorbent beads that can actively remove toxic substances from blood and other bodily fluids by pore capture and surface absorption. The Company has numerous products under development based upon this unique blood purification technology, which is protected by 19 issued U.S. patents and multiple international patents, with applications pending both in the U.S. and internationally, including HemoDefend, ContrastSorb, DrugSorb, and others. These patents and patent applications are directed to various compositions and methods of use related to our blood purification technologies and are expected to expire between 2020 and 2035, absent any patent term extensions. Management believes that any near term expiring patents will not have a significant impact on our ongoing business.
Stock Market Listing	Stock Market Listing On December 17, 2014 the Company’s common stock, par value $0.001 per share, was approved for listing on the Nasdaq Capital Market (“Nasdaq”), and it began trading on Nasdaq on December 23, 2014 under the symbol “CTSO.” Previously, the Company’s common stock traded in the over-the-counter-market on the OTC Bulletin Board.
Basis of Consolidation and Foreign Currency Translation	Basis of Consolidation and Foreign Currency Translation The consolidated financial statements include the accounts of CytoSorbents Corporation and its wholly-owned subsidiaries, CytoSorbents Medical, Inc. and CytoSorbents Europe GmbH. In addition, the financial statements include CytoSorbents Switzerland GmbH and CytoSorbents Poland Sp. z.o.o., wholly owned subsidiaries of CytoSorbents Europe GmbH. All significant intercompany transactions and balances have been eliminated in consolidation. Translation gains and losses resulting from the process of remeasuring into the United States Dollar, the foreign currency financial statements of CytoSorbents Europe GmbH, for which the Euro is the functional currency, are included in operations. Foreign currency transaction gain (loss) included in net loss amounted to approximately $(393,000) and $358,000 for the three months ended March 31, 2019 and 2018, respectively. The Company translates assets and liabilities of CytoSorbents Europe GmbH at the exchange rate in effect at the balance sheet date. The Company translates revenue and expenses at the daily average exchange rates. The Company includes accumulated net translation adjustments in accumulated other comprehensive income (loss) as a component of stockholders’ equity.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all highly liquid investments purchased with an original maturity of three months or less to be cash equivalents.
Grants and Accounts Receivable	Grants and Accounts Receivable Grants receivable represent amounts due from U.S. government agencies and are included in Grants and Accounts Receivable. Accounts receivable are unsecured, non-interest bearing customer obligations due under normal trade terms. The Company sells its devices to various hospitals and distributors. The Company performs ongoing credit evaluations of its customers’ financial conditions. Management reviews accounts receivable periodically to determine collectability. Balances that are determined to be uncollectible are written off to the allowance for doubtful accounts. The allowance for doubtful accounts contains a general accrual for estimated bad debts and amounted to approximately $85,000 and $84,000 at March 31, 2019 and December 31, 2018, respectively.
Inventories	Inventories Inventories are valued at the lower of cost or net realizable value under the first in, first out (FIFO) method. At March 31, 2019 and December 31, 2018, the Company’s inventory was comprised of finished goods, which amounted to $382,651 and $213,839, respectively; work in process which amounted to $572,937 and $415,265, respectively; and raw materials, which amounted to $258,018 and $204,029, respectively. Devices used in clinical trials or for research and development purposes are removed from inventory and charged to research and development expenses at the time of their use.
Property and Equipment	Property and Equipment Property and equipment are recorded at cost less accumulated depreciation. Depreciation of property and equipment is provided for by the straight-line method over the estimated useful lives of the related assets. Leasehold improvements are amortized over the lesser of their economic useful lives or the term of the related leases. Gains and losses on depreciable assets retired or sold are recognized in the statements of operations in the year of disposal. Repairs and maintenance expenditures are expensed as incurred.
Patents	Patents Legal costs incurred to establish and successfully defend patents are capitalized. When patents are issued, capitalized costs are amortized on the straight-line method over the related patent term. In the event a patent is abandoned, the net book value of the patent is written off.
Impairment or Disposal of Long-Lived Assets	Impairment or Disposal of Long-Lived Assets The Company assesses the impairment of patents and other long-lived assets under accounting standards for the impairment or disposal of long-lived assets whenever events or changes in circumstances indicate that the carrying value may not be recoverable. For long-lived assets to be held and used, the Company recognizes an impairment loss only if its carrying amount is not recoverable through its undiscounted cash flows and measures the impairment loss based on the difference between the carrying amount and fair value.
Revenue Recognition	Revenue Recognition Product Sales : Revenues from sales of products to both direct and distributor/strategic partner customers are recognized at the time when control passes to the customer, in accordance with the terms of their respective contracts. Recognition of revenue occurs as each performance obligation is completed. Grant Income : Revenue from grant income is based on contractual agreements. Certain agreements provide for reimbursement of costs, while other agreements provide for reimbursement of costs and an overhead margin. Revenues are recognized when the associated performance obligation is fulfilled. Costs are recorded as incurred. Costs subject to reimbursement by these grants have been reflected as costs of revenue.
Research and Development	Research and Development All research and development costs, payments to laboratories and research consultants are expensed when incurred.
Advertising Expenses	Advertising Expenses Advertising expenses are charged to activities when incurred. Advertising expenses amounted to approximately $51,800 and $36,762 for the three months ended March 31, 2019 and 2018, respectively, and are included in selling, general, and administrative expenses on the consolidated statement of operations.
Income Taxes	Income Taxes Income taxes are accounted for under the asset and liability method prescribed by accounting standards for accounting for income taxes. Deferred income taxes are recorded for temporary differences between financial statement carrying amounts and the tax basis of assets and liabilities. Deferred tax assets and liabilities reflect the tax rates expected to be in effect for the years in which the differences are expected to reverse. A valuation allowance is provided if it is more likely than not that some or all of the deferred tax asset will not be realized. The Company has provided a valuation allowance against all deferred tax assets. Under Section 382 of the Internal Revenue Code, the net operating losses generated prior to the previously completed reverse merger may be limited due to the change in ownership. Additionally, net operating losses generated subsequent to the reverse merger may be limited in the event of changes in ownership. The Company follows accounting standards associated with uncertain tax positions. The Company had no unrecognized tax benefits at March 31, 2019 or December 31, 2018. The Company files tax returns in the U.S. federal and state jurisdictions. The Company utilizes the Technology Business Tax Certificate Transfer Program to sell a portion of its New Jersey Net Operating Loss carry forwards to an industrial company. Each of CytoSorbents Europe GmbH, CytoSorbents Switzerland GmbH and CytoSorbents Poland Sp. Z.o.o. file an annual corporate tax return, VAT return and a trade tax return in Germany, Switzerland and Poland, respectively.
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities. Actual results could differ from these estimates. Significant estimates in these financials are the valuation of options granted, and valuation methods used to determine the change in fair value of the down round feature related to certain of the Company’s outstanding warrants.
Concentration of Credit Risk	Concentration of Credit Risk The Company maintains cash balances, at times, with financial institutions in excess of amounts insured by the Federal Deposit Insurance Corporation. Management monitors the soundness of these institutions in an effort to minimize its collection risk of these balances. A significant portion of our revenues are from product sales in Germany. Substantially all of our grant and other income are from grant agencies in the United States. (See Note 4 for further information relating to the Company’s revenue.) As of March 31, 2019, one distributor accounted for approximately 20% of outstanding grants and accounts receivable. As of March 31, 2018, one distributor accounted for approximately 11% of outstanding grants and accounts receivable. As of December 31, 2018, two distributors/strategic partners accounted for approximately 29% of the outstanding grants and accounts receivable. For the three months ended March 31, 2019 and 2018, no agency, distributor, or direct customer represented more than 10% of the Company’s total revenue.
Financial Instruments	Financial Instruments The carrying values of cash and cash equivalents, short-term investments, accounts payable, notes payable, and other debt obligations approximate their fair values due to their short-term nature.
Net Loss Per Common Share	Net Loss Per Common Share Basic earnings per share is computed by dividing loss available to common stockholders by the weighted average number of common shares outstanding during the period. Diluted earnings per common share is computed using the treasury stock method on the basis of the weighted-average number of shares of common stock plus the dilutive effect of potential common shares outstanding during the period. Dilutive potential common shares include outstanding warrants, stock options and restricted shares. The computation of diluted earnings per share does not assume conversion, exercise or contingent exercise of securities that would have an anti-dilutive effect on earnings (See Note 8).
Stock-Based Compensation	Stock-Based Compensation The Company accounts for its stock-based compensation under the recognition requirements of accounting standards for accounting for stock-based compensation, for employees and directors whereby each option granted is valued at fair market value on the date of grant. Under these accounting standards, the fair value of each option is estimated on the date of grant using the Black-Scholes option pricing model. The Company also follows the guidance of accounting standards for accounting for equity instruments that are issued to other than employees for acquiring, or in conjunction with selling, goods or services for equity instruments issued to consultants.
Effects of Recent Accounting Pronouncements	Effects of Recent Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, “Leases (Topic 842)”. ASU 2016-02 outlines reporting requirements for lessees to recognize a right-of-use asset and corresponding liability on the balance sheet for all leases covering a period of greater than 12 months. The liability is to be measured as the present value of the future minimum lease payments, plus any initial direct costs. The minimum payments are discounted using the rate implicit in the lease, or, if not known, the lessee’s incremental borrowing rate. The updated guidance is effective for public entities for fiscal years beginning after December 31, 2018. The Company has adopted the updated guidance effective January 1, 2019. See Note 7 for details regarding the Company’s leases.
Shipping and Handling Costs	Shipping and Handling Costs The cost of shipping product to customers and distributors is typically borne by the customer or distributor. The Company records other shipping and handling costs in cost of revenue. Total freight costs amounted to approximately $146,500 and $135,800, respectively, for the three months ended March 31, 2019 and 2018.
Reclassifications	Reclassifications Certain reclassifications have been made to the March 31, 2018 financial statements in order to conform to the 2019 financial statement presentation. There was no change in the reported amount of the accumulated deficit as a result of these reclassifications.

STOCKHOLDERS' EQUITY (Tables)

STOCKHOLDERS' EQUITY (Tables)	3 Months Ended
	Mar. 31, 2019
Stockholders' Equity Note [Abstract]
Schedule Of Share Based Compensation Stock Options Activity	The summary of the stock option activity for the three months ended March 31, 2019 is as follows: Weighted Weighted Average Average Remaining Exercise Price Contractual Shares per Share Life (Years) Outstanding, December 31, 2018 3,658,462 $ 5.82 7.0 Granted 60,800 $ 6.99 9.3 Forfeited (34,817 ) $ 7.56 — Expired (4,000 ) $ 4.20 — Exercised (55,642 ) $ 4.58 — Outstanding, March 31, 2019 3,624,803 $ 5.86 6.8
Schedule of Share-based Compensation, Shares Authorized under Stock Option Plans, by Exercise Price Range	The intrinsic value is calculated at the difference between the market value as of March 31, 2019 of $7.57 and the exercise price of the shares. Options Outstanding Number Weighted Weighted Range of Outstanding at Average Average Aggregate Exercise March 31, Exercise Remaining Intrinsic Price 2019 Price Life (Years) Value $2.23 - $14.80 3,624,803 $ 5.86 6.8 $ 6,899,653 Options Exercisable Number Weighted Exercisable at Average Aggregate March 31, Exercise Intrinsic 2019 Price Value 2,845,173 $ 5.36 $ 6,486,837
Schedule Of Nonvested Share Activity	The summary of the status of the Company’s non-vested options for the three months ended March 31, 2019 is as follows: Weighted Average Grant Date Shares Fair Value Non-vested, December 31, 2018 1,251,617 $ 4.56 Granted 60,800 $ 4.00 Forfeited (34,817 ) $ 4.57 Vested (497,970 ) $ 6.90 Non-vested, March 31, 2019 779,630 $ 4.65
Schedule of Share-based Compensation, Restricted Stock Units Award Activity	The following table is a summary of these restricted stock units: Restricted Stock Units Board of Executive Other Directors Management Employees Total Intrinsic Value December 31, 2018 277,200 724,500 1,002,300 2,004,000 $ 16,192,320 Granted - - - - Forfeited - - (6,000 ) (6,000 ) March 31, 2019 277,200 724,500 996,300 1,998,000 $ 15,124,860
Schedule Of Restricted Stock Unit Activity	The following table outlines the restricted stock unit activity for the three months ended March 31, 2019: Weighted Average Grant Date Shares Fair Value Non-vested, January 1, 2019 139,138 $ 7.18 Granted 22,220 $ 8.05 Vested (97,806 ) $ 6.63 Non-vested, March 31, 2019 63,552 $ 7.90

REVENUE (Tables)

REVENUE (Tables)	3 Months Ended
	Mar. 31, 2019
Revenue from Contract with Customer [Abstract]
Disaggregation of Revenue	The following table disaggregates the Company’s revenue by customer type and geographic area for the three months ended March 31, 2019: United States Distributors/ Government Direct Strategic Partners Agencies Total Product sales: United States $ 66,800 $ – $ – $ 66,800 Germany 3,098,176 – – 3,098,176 All other countries 816,229 595,374 – 1,411,603 Total product revenue 3,981,205 595,374 – 4,576,579 Grant and other income: United States – – 615,050 615,050 Total revenue $ 3,981,205 $ 595,374 $ 615,050 $ 5,191,629 The following table disaggregates the Company’s revenue by customer type and geographic area for the three months ended March 31, 2018: United States Distributors/ Government Direct Strategic Partners Agencies Total Product sales: United States $ 1,800 $ – $ – $ 1,800 Germany 2,667,408 – – 2,667,408 All other countries 693,404 1,070,684 – 1,764,088 Total product revenue 3,362,612 1,070,684 – 4,433,296 Grant and other income: United States – – 491,355 491,355 Total revenue $ 3,362,612 $ 1,070,684 $ 491,355 $ 4,924,651
Contract with Customer, Asset and Liability	The following table provides information about receivables and contract liabilities from contracts with customers: March 31, 2019 December 31, 2018 Receivables, which are included in grants and accounts receivable $ 1,950,155 $ 2,399,662 Contract liabilities $ 10,462 $ 42,219

LONG-TERM DEBT, NET (Tables)

LONG-TERM DEBT, NET (Tables)	3 Months Ended
	Mar. 31, 2019
Debt Disclosure [Abstract]
Schedule of Long-term Debt	Long-term debt consists of the following at March 31, 2019: Principal amount $ 10,000,000 Less unamortized debt acquisition costs (97,552 ) Plus accrued final fee 62,500 Subtotal 9,964,948 Less Current maturities (1,666,667 ) Long-term debt net of current maturities $ 8,298,281
Schedule of Principal payments of long-term debt	Required principal payments of long-term debt for the twelve months ended March 31, are as follows: 2020 $ 1,666,667 2021 4,000,000 2022 4,000,000 2023 333,333 Total $ 10,000,000

LEASES (Tables)

LEASES (Tables)	3 Months Ended
	Mar. 31, 2019
Leases, Operating [Abstract]
Schedule Of Right-Of-Asset And Related Lease Liability	As a result, the value of the right-of-asset and related lease liability is as follows: March 31, December 31, 2019 2018 Right-of-use asset $ 1,359,097 $ 1,449,437 Total lease liability $ 1,359,097 $ 1,449,437 Less current portion (388,915 ) (378,675 ) Lease liability, net of current portion $ 970,182 $ 1,070,762
Schedule of Maturities of Lease Liabilities	The maturities of the lease liabilities are as follows as of March 31, 2019: 2020 $ 388,915 2021 442,865 2022 136,098 2023 75,308 2024 82,503 Thereafter 233,408 Total $ 1,359,097

BASIS OF PRESENTATION (Details

BASIS OF PRESENTATION (Details Textual) - USD ($)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
BASIS OF PRESENTATION [Line Items]
Accumulated deficit	$ (174,407,642)		$ (169,523,815)
Net income (loss)	$ (4,883,827)	$ (2,982,035)

PRINCIPAL BUSINESS ACTIVITY A_3

PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details Textual) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018	Dec. 17, 2014
Principal Business Activity and Summary of Significant Accounting Policies [Line Items]
Foreign Currency Transaction Gain (Loss), before Tax	$ (393,455)	$ 358,230
Allowance for Doubtful Accounts Receivable	85,460		$ 83,726
Inventory, Finished Goods, Gross	382,651		213,839
Inventory, Work in Process, Gross	572,937		415,265
Inventory, Raw Materials, Gross	258,018		$ 204,029
Advertising Expense	51,800	36,762
Cost of Goods and Services Sold	$ 1,738,589	1,567,645
Common Stock, Par Value	$ 0.001		$ 0.001	$ 0.001
Cargo and Freight [Member]
Principal Business Activity and Summary of Significant Accounting Policies [Line Items]
Cost of Goods and Services Sold	$ 146,500	$ 135,800
Accounts Receivable [Member] | one distributor/strategic partners
Principal Business Activity and Summary of Significant Accounting Policies [Line Items]
Concentration Risk, Percentage	20.00%	11.00%
Accounts Receivable [Member] | two distributors/strategic partners
Principal Business Activity and Summary of Significant Accounting Policies [Line Items]
Concentration Risk, Percentage			29.00%
Sales Revenue, Goods, Net [Member]
Principal Business Activity and Summary of Significant Accounting Policies [Line Items]
Concentration Risk, Percentage	10.00%	10.00%

STOCKHOLDERS' EQUITY (Details)

STOCKHOLDERS' EQUITY (Details)	3 Months Ended
	Mar. 31, 2019$ / sharesshares
Shares
Outstanding | shares	3,658,462
Granted | shares	60,800
Forfeited | shares	(34,817)
Expired | shares	(4,000)
Exercised | shares	(55,642)
Outstanding | shares	3,624,803
Weighted Average Exercise Price per Share
Outstanding | $ / shares	$ 5.82
Granted | $ / shares	6.99
Forfeited | $ / shares	7.56
Expired | $ / shares	4.20
Exercised | $ / shares	4.58
Outstanding | $ / shares	$ 5.86
Weighted Average Remaining Contractual Life (Years)
Outstanding	7 years
Granted	9 years 3 months 18 days
Forfeited	0 years
Expired	0 years
Exercised	0 years
Outstanding	6 years 9 months 18 days

STOCKHOLDERS' EQUITY (Details 1

STOCKHOLDERS' EQUITY (Details 1)	3 Months Ended
	Mar. 31, 2019USD ($)$ / sharesshares
Options Outstanding
Number Outstanding at March 31, 2019 | shares	3,624,803
Weighted Average Exercise Price	$ 5.86
Weighted Average Remaining Life (Years)	6 years 9 months 18 days
Aggregate Intrinsic Value | $	$ 6,899,653
Options Exercisable
Number Exercisable at March 31, 2019 | shares	2,845,173
Weighted Average Exercise Price	$ 5.36
Aggregate Intrinsic Value | $	$ 6,486,837
$0.88 - $9.78
Options Outstanding
Range of Exercise Price, Lower Range Limit	$ 2.23
Range of Exercise Price, Upper Range Limit	$ 14.80

STOCKHOLDERS' EQUITY (Details 2

STOCKHOLDERS' EQUITY (Details 2)	3 Months Ended
	Mar. 31, 2019$ / sharesshares
Shares
Non-vested, December 31, 2018 | shares	1,251,617
Granted | shares	60,800
Forfeited | shares	(34,817)
Vested | shares	(497,970)
Non-vested, March 31, 2019 | shares	779,630
Weighted Average Grant Date Fair Value
Non-vested, December 31, 2018 | $ / shares	$ 4.56
Granted | $ / shares	4
Forfeited | $ / shares	4.57
Vested | $ / shares	6.90
Non-vested, March 31, 2019 | $ / shares	$ 4.65

STOCKHOLDERS' EQUITY (Details 3

STOCKHOLDERS' EQUITY (Details 3)	3 Months Ended
	Mar. 31, 2019USD ($)shares
Board of Directors [Member]
Restricted Stock Units, Forfeited	0
Executive Management [Member]
Restricted Stock Units, Forfeited	0
Restricted Stock Units (RSUs) [Member]
Restricted Stock Units, Beginning Balance	2,004,000
Restricted Stock Units, Intrinsic Value Beginning Balance | $	$ 16,192,320
Restricted Stock Units, Granted	0
Restricted Stock Units, Forfeited	(6,000)
Restricted Stock Units, Ending Balance	1,998,000
Restricted Stock Units, Intrinsic Value Ending Balance | $	$ 15,124,860
Restricted Stock Units (RSUs) [Member] | Board of Directors [Member]
Restricted Stock Units, Beginning Balance	277,200
Restricted Stock Units, Granted	0
Restricted Stock Units, Ending Balance	277,200
Restricted Stock Units (RSUs) [Member] | Executive Management [Member]
Restricted Stock Units, Beginning Balance	724,500
Restricted Stock Units, Granted	0
Restricted Stock Units, Ending Balance	724,500
Restricted Stock Units (RSUs) [Member] | Other Employees [Member]
Restricted Stock Units, Beginning Balance	1,002,300
Restricted Stock Units, Granted	0
Restricted Stock Units, Forfeited	(6,000)
Restricted Stock Units, Ending Balance	996,300

STOCKHOLDERS' EQUITY (Details 4

STOCKHOLDERS' EQUITY (Details 4) - Restricted Stock Units (RSUs) [Member]	3 Months Ended
	Mar. 31, 2019$ / sharesshares
Shares
Non-vested, January 1, 2018 | shares	139,138
Granted | shares	22,220
Vested | shares	(97,806)
Non-vested, March 31, 2019 | shares	63,552
Weighted Average Grant Date Fair Value
Non-vested, January 1, 2018 | $ / shares	$ 7.18
Granted | $ / shares	8.05
Vested | $ / shares	6.63
Non-vested, March 31, 2019 | $ / shares	$ 7.90

STOCKHOLDERS' EQUITY (Details 5

STOCKHOLDERS' EQUITY (Details 5)	3 Months Ended
	Mar. 31, 2019$ / sharesshares
Class of Warrant or Right [Line Items]
Number of Shares To be Purchased | shares	30,000
Warrant Exercise Price per Share | $ / shares	$ 9.90
Warrant Expiration Date	Jan. 14, 2020

STOCKHOLDERS' EQUITY (Details T

STOCKHOLDERS' EQUITY (Details Textual) - USD ($)	1 Months Ended			2 Months Ended	3 Months Ended			12 Months Ended
	Mar. 04, 2019	Feb. 28, 2018	Feb. 24, 2017	Dec. 31, 2015	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2015	Dec. 31, 2018	Dec. 31, 2017	Jul. 29, 2015	Dec. 31, 2014
Stockholders Equity [Line Items]
Preferred Stock, Shares Authorized					5,000,000			5,000,000
Stock Issued During Period Value New Issues						$ 6,046,761
Aggregate registered amount for offerings										$ 150
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Exercise Price					$ 7.57
Shares Issued, Price Per Share								$ 9.61
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Number					3,624,803			3,658,462
Allocated Share-based Compensation Expense					$ 228,000	524,000
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Risk Free Interest Rate, Minimum					2.24%
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Risk Free Interest Rate, Maximum					2.61%
Employee Service Share-based Compensation, Nonvested Awards, Compensation Not yet Recognized, Stock Options					$ 800,000
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures					$ 425,639	380,899
Sale of Stock, Price Per Share					$ 8.72
Sale of Stock, Number of Shares Issued in Transaction					2,094,140
Sale of Stock, Consideration Received on Transaction					$ 17,718,000
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Dividend Rate					0.00%
Restricted Stock Units (RSUs) [Member]
Stockholders Equity [Line Items]
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures					$ 5,000	0
Stock Issued During Period, Shares, Restricted Stock Award, Gross	22,220
Stock Issued During Period, Value, Restricted Stock Award, Gross	$ 179,000
November 4, 2015 Equity Offering [Member]
Stockholders Equity [Line Items]
Stock Issued During Period Shares New Issues							28,880	1,515,260	550,000
Stock Issued During Period Value New Issues							$ 225,000	$ 14,127,000	$ 3,367,000
Shares Issued, Price Per Share									$ 6.31
Cantor Fitzgerald and Co. [Member]
Stockholders Equity [Line Items]
Commission Rate As Percentage Of Aggregate Gross Proceeds					3.00%
Maximum Amount To Be Reimbursed For Expenses In Connection With Agreement				$ 50,000
Maximum [Member] | Restricted Stock Units (RSUs) [Member]
Stockholders Equity [Line Items]
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures					$ 150,000	154,000
Stock Issued During Period, Shares, Restricted Stock Award, Gross			125,000
Stock Issued During Period, Value, Restricted Stock Award, Gross			$ 700,000
Minimum [Member] | Restricted Stock Units (RSUs) [Member]
Stockholders Equity [Line Items]
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures					$ 107,000	$ 32,000
Stock Issued During Period, Shares, Restricted Stock Award, Gross		146,200
Stock Issued During Period, Value, Restricted Stock Award, Gross		$ 1,148,000
Series A Preferred Stock [Member]
Stockholders Equity [Line Items]
Preferred Stock, Shares Authorized											5,000,000
Exercise Price Ranging From 6.85 to 9.78 [Member] | Maximum [Member]
Stockholders Equity [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Number					8.10
Exercise Price Ranging From 6.85 to 9.78 [Member] | Minimum [Member]
Stockholders Equity [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Exercise Price					$ 6.98
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Volatility Rate					61.90%

REVENUE (Details)

REVENUE (Details) - USD ($)	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Product sales:
Revenue from Contract with Customer, Including Assessed Tax	$ 4,576,579	$ 4,433,296
Grant and other income:
Revenue From Grant	615,050	491,355
Total revenue	5,191,629	4,924,651
United States
Product sales:
Revenue from Contract with Customer, Including Assessed Tax	66,800	1,800
Grant and other income:
Revenue From Grant	615,050	491,355
Germany
Product sales:
Revenue from Contract with Customer, Including Assessed Tax	3,098,176	2,667,408
All other countries
Product sales:
Revenue from Contract with Customer, Including Assessed Tax	1,411,603	1,764,088
Direct [Member]
Product sales:
Revenue from Contract with Customer, Including Assessed Tax	3,981,205	3,362,612
Grant and other income:
Total revenue	3,981,205	3,362,612
Direct [Member] | United States
Product sales:
Revenue from Contract with Customer, Including Assessed Tax	66,800	1,800
Grant and other income:
Revenue From Grant	0	0
Direct [Member] | Germany
Product sales:
Revenue from Contract with Customer, Including Assessed Tax	3,098,176	2,667,408
Direct [Member] | All other countries
Product sales:
Revenue from Contract with Customer, Including Assessed Tax	816,229	693,404
Distributors And Strategic Partners [Member]
Product sales:
Revenue from Contract with Customer, Including Assessed Tax	595,374	1,070,684
Grant and other income:
Total revenue	595,374	1,070,684
Distributors And Strategic Partners [Member] | United States
Product sales:
Revenue from Contract with Customer, Including Assessed Tax	0	0
Grant and other income:
Revenue From Grant	0	0
Distributors And Strategic Partners [Member] | Germany
Product sales:
Revenue from Contract with Customer, Including Assessed Tax	0	0
Distributors And Strategic Partners [Member] | All other countries
Product sales:
Revenue from Contract with Customer, Including Assessed Tax	595,374	1,070,684
United States Government Agencies [Member]
Product sales:
Revenue from Contract with Customer, Including Assessed Tax	0	0
Grant and other income:
Total revenue	615,050	491,355
United States Government Agencies [Member] | United States
Product sales:
Revenue from Contract with Customer, Including Assessed Tax	0	0
Grant and other income:
Revenue From Grant	615,050	491,355
United States Government Agencies [Member] | Germany
Product sales:
Revenue from Contract with Customer, Including Assessed Tax	0	0
United States Government Agencies [Member] | All other countries
Product sales:
Revenue from Contract with Customer, Including Assessed Tax	$ 0	$ 0

REVENUE (Details 1)

REVENUE (Details 1) - USD ($)	Mar. 31, 2019	Dec. 31, 2018
Receivables, which are included in grants and accounts receivable	$ 1,950,155	$ 2,399,662
Contract liabilities	$ 10,462	$ 42,219

REVENUE (Details Textual)

REVENUE (Details Textual)	3 Months Ended
	Mar. 31, 2019
Maximum [Member]
Term Of Customer Contracts	5 years
Minimum [Member]
Term Of Customer Contracts	1 year

LONG-TERM DEBT, NET (Details)

LONG-TERM DEBT, NET (Details) - USD ($)	Mar. 31, 2019	Dec. 31, 2018
Principal amount	$ 10,000,000
Less unamortized debt acquisition costs	(97,552)
Plus accrued final fee	62,500
Subtotal	9,964,948
Less Current maturities	(1,666,667)	$ (666,667)
Long-term debt net of current maturities	$ 8,298,281	$ 9,274,527

LONG-TERM DEBT, NET (Details 1)

LONG-TERM DEBT, NET (Details 1)	Mar. 31, 2019USD ($)
2020	$ 1,666,667
2021	4,000,000
2022	4,000,000
2023	333,333
Total	$ 10,000,000

LONG-TERM DEBT, NET (Details Te

LONG-TERM DEBT, NET (Details Textual) - USD ($)	1 Months Ended	3 Months Ended
	May 23, 2018	Mar. 31, 2019	Mar. 31, 2018	Mar. 29, 2018	Jun. 30, 2016
Debt Issuance Costs, Net		$ 97,552
Long-term Debt		$ 9,964,948
Stock Issued During Period, Shares, Other	68,791
Other Noncash Expense	$ 637,000
Percentage Of Non-Refundable Final Fee		2.50%
Term A Loan [Member]
Debt Instrument, Interest Rate, Effective Percentage				9.10%
Non refundable Closing Fee [Member]
Interest Expense, Debt		$ 8,129	$ 7,558
Non refundable Final Fee [Member]
Interest Expense, Debt		$ 15,625	$ 18,229
Western Alliance Bank [Member]
Debt Instrument, Face Amount				$ 15,000,000	$ 10,000,000
Debt Instrument, Interest Rate, Stated Percentage		9.16%
Debt Issuance Costs, Net		$ 130,060
Percentage Of Success Fee		6.37%
Share Price		$ 8
Term Loan Interest LIBRO Rate Adjusted Monthly		3.66%
Western Alliance Bank [Member] | First Anniversary [Member]
Debt Instrument, Periodic Payment		$ 333,333
Percentage Of Prepayment Interest		2.00%
Western Alliance Bank [Member] | Second Anniversary [Member]
Percentage Of Prepayment Interest		1.50%
Western Alliance Bank [Member] | Third Anniversary [Member]
Percentage Of Prepayment Interest		1.00%
Western Alliance Bank [Member] | Closing Fee [Member]
Debt Issuance Costs, Net		$ 25,000
Western Alliance Bank [Member] | Bank Related Expenses [Member]
Debt Issuance Costs, Net		11,000
Western Alliance Bank [Member] | Legal Expenses [Member]
Debt Issuance Costs, Net		20,050
Long-term Debt		$ 85,938
Western Alliance Bank [Member] | Term A Loan [Member]
Debt Instrument, Face Amount				10,000,000	$ 5,000,000
Western Alliance Bank [Member] | Term B Loan [Member]
Debt Instrument, Face Amount				$ 5,000,000

COMMITMENTS AND CONTINGENCIES (

COMMITMENTS AND CONTINGENCIES (Details Textual) - USD ($)	Aug. 11, 2003	Mar. 31, 2019	Mar. 31, 2018
Commitments and Contingencies Disclosure [Line Items]
Term of License Agreement		18 years
Royalty Agreements [Member]
Commitments and Contingencies Disclosure [Line Items]
Future royalty payment percentage on gross revenue	3.00%
Royalty cost		$ 134,000	$ 131,000
Equity investment by an existing investor	$ 4,000,000
License Agreement [Member]
Commitments and Contingencies Disclosure [Line Items]
Royalty rate, lower limit		2.50%
Royalty rate, upper limit		5.00%
Royalty cost		$ 224,000	$ 219,000

LEASES (Details)

LEASES (Details) - USD ($)	Mar. 31, 2019	Dec. 31, 2018
Leases, Operating [Abstract]
Right of use asset	$ 1,359,097	$ 1,449,437
Total lease liability	1,359,097	1,449,437
Less current portion	(388,915)	(378,675)
Lease liability, net of current portion	$ 970,182	$ 1,070,762

LEASES (Details 1)

LEASES (Details 1)	Mar. 31, 2019USD ($)
Leases, Operating [Abstract]
2020	$ 388,915
2021	442,865
2022	136,098
2023	75,308
2024	82,503
Thereafter	233,408
Total	$ 1,359,097

LEASES (Details Textual)

LEASES (Details Textual)	3 Months Ended		16 Months Ended
	Mar. 31, 2019USD ($)	Mar. 31, 2018USD ($)	May 31, 2020	Feb. 01, 2019ft²	Dec. 31, 2018
Lease Expiration Date	Aug. 31, 2021
Lessee, Operating Lease, Discount Rate					9.16%
Operating Lease, Payments	$ 215,000	$ 199,000
Operating Lease, Weighted Average Remaining Lease Term	4 years 3 months				4 years 6 months
UNITED STATES
Area of Land | ft²				19,920
Lease Expiration Date			May 31, 2020
Operating Leases, Rent Expense, Net	$ 32,000
Additional Operating Leases Rent Expense Net	29,000
Germany
Operating Leases, Rent Expense, Net	8,800
Additional Operating Leases Rent Expense Net	$ 2,900

NET LOSS PER SHARE (Details Tex

NET LOSS PER SHARE (Details Textual) - shares	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Stock Options and Warrants [Member]
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	5,716,000	6,848,000