Cytosorbents (CTSO) 10-Q 7 Nov 24 2024 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2024	Nov. 05, 2024
Document and Entity Information
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2024
Document Transition Report	false
Entity File Number	001-36792
Entity Registrant Name	CYTOSORBENTS CORPORATION
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	98-0373793
Entity Address, Address Line One	305 College Road East
Entity Address, City or Town	Princeton,
Entity Address, State or Province	NJ
Entity Address, Postal Zip Code	08540
City Area Code	732
Local Phone Number	329-8885
Title of 12(b) Security	Common Stock, $0.001 par value per share
Trading Symbol	CTSO
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		54,679,569
Entity Central Index Key	0001175151
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q3
Amendment Flag	false

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($)	Sep. 30, 2024	Dec. 31, 2023
Current Assets:
Cash and cash equivalents	$ 5,685,328	$ 14,131,137
Grants and accounts receivable, net of allowance of $160,246 as of September 30, 2024 and $49,663 at December 31, 2023	6,632,590	6,057,072
Inventories	3,247,756	3,680,129
Prepaid expenses and other current assets	1,031,694	1,834,485
Total current assets	16,597,368	25,702,823
Property and equipment, net	9,269,899	10,056,354
Restricted cash	6,483,958	1,483,958
Right-of-use assets	11,651,563	12,058,896
Other assets	3,801,223	3,958,603
Total Assets	47,804,011	53,260,634
Current Liabilities:
Accounts payable	2,338,143	3,802,170
Current maturities of long-term debt		2,500,000
Lease liability - current portion	431,997	373,636
Accrued expenses and other current liabilities	5,660,051	7,870,149
Total current liabilities	8,430,191	14,545,955
Lease liability, net of current portion	12,568,745	12,896,659
Long-term debt	13,805,985	2,542,857
Total Liabilities	34,804,921	29,985,471
Commitments and Contingencies (Note 6)
Stockholders' Equity:
Preferred Stock, Par Value $0.001, 5,000,000 shares authorized; no shares issued and outstanding at September 30, 2024 and December 31, 2023
Common Stock, Par Value $0.001, 100,000,000 shares authorized; 54,500,613 and 54,240,265 shares issued and outstanding as of September 30, 2024 and December 31, 2023, respectively	54,498	54,240
Additional paid-in capital	308,441,887	305,196,874
Accumulated other comprehensive income (loss)	(156,925)	529,321
Accumulated deficit	(295,340,370)	(282,505,272)
Total Stockholders' Equity	12,999,090	23,275,163
Total Liabilities and Stockholders' Equity	$ 47,804,011	$ 53,260,634

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($)	Sep. 30, 2024	Dec. 31, 2023
CONDENSED CONSOLIDATED BALANCE SHEETS
Grants and accounts receivable, net of allowance for doubtful accounts	$ 160,246	$ 49,663
Preferred Stock, Par Value (in dollars per share)	$ 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 (in dollars per share)	$ 0.001	$ 0.001
Common Stock, shares authorized	100,000,000	100,000,000
Common Stock, shares issued	54,500,613	54,240,265
Common Stock, shares outstanding	54,500,613	54,240,265

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Revenue:
Total revenue	$ 9,390,388	$ 8,810,847	$ 29,071,316	$ 27,681,164
Cost of revenue	4,108,773	3,203,981	10,716,394	10,600,421
Gross profit	5,281,615	5,606,866	18,354,922	17,080,743
Other expenses:
Research and development	1,851,230	3,749,197	5,619,040	11,632,416
Legal, financial and other consulting	823,914	1,103,475	2,325,351	2,957,738
Selling, general and administrative	7,002,718	8,104,392	23,151,118	24,358,417
Total expenses	9,677,862	12,957,064	31,095,509	38,948,571
Loss from operations	(4,396,247)	(7,350,198)	(12,740,587)	(21,867,828)
Other income (expense):
Interest expense, net	(588,153)	(33,670)	(774,903)	(105,662)
Gain (loss) on foreign currency transactions	2,650,309	(1,809,652)	680,392	(733,997)
Miscellaneous income				35,000
Total other income (expense), net	2,062,156	(1,843,322)	(94,511)	(804,659)
Loss before benefit from income taxes	(2,334,091)	(9,193,520)	(12,835,098)	(22,672,487)
Benefit from income taxes	0	0	0	0
Net loss attributable to common stockholders	$ (2,334,091)	$ (9,193,520)	$ (12,835,098)	$ (22,672,487)
Basic net loss per common share	$ (0.04)	$ (0.21)	$ (0.24)	$ (0.52)
Diluted net loss per common share	$ (0.04)	$ (0.21)	$ (0.24)	$ (0.52)
Weighted average number of shares of common stock outstanding, basic	54,453,006	44,373,969	54,340,583	44,024,483
Weighted average number of shares of common stock outstanding, diluted	54,453,006	44,373,969	54,340,583	44,024,483
Comprehensive loss:
Net loss	$ (2,334,091)	$ (9,193,520)	$ (12,835,098)	$ (22,672,487)
Other comprehensive income (loss):
Foreign currency translation adjustment	(2,330,743)	1,655,674	(686,246)	654,792
Comprehensive loss	(4,664,834)	(7,537,846)	(13,521,344)	(22,017,695)
Total product sales
Revenue:
Total revenue	8,612,795	7,754,016	26,444,104	23,736,468
CytoSorb sales
Revenue:
Total revenue	8,586,274	7,709,085	26,381,455	23,681,183
Other product sales
Revenue:
Total revenue	26,521	44,931	62,649	55,285
Grant income
Revenue:
Total revenue	$ 777,593	$ 1,056,831	$ 2,627,212	$ 3,944,696

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS' EQUITY - USD ($)	Common Stock	Additional Paid-In Capital	Accumulated Other Comprehensive Income (Loss)	Accumulated Deficit	Total
Balance at Dec. 31, 2022	$ 43,635	$ 287,000,021	$ 2,329,195	$ (253,997,878)	$ 35,374,973
Balance (in shares) at Dec. 31, 2022	43,635,715
Stock-based compensation - employees, consultants and directors		2,486,679			2,486,679
Issuance of common stock offerings, net of fees	$ 591	2,106,528			2,107,119
Issuance of common stock offerings, net of fees (in shares)	590,348
ATM fee		(56,702)			(56,702)
Proceeds from exercise of stock options for cash	$ 83	213,224			213,307
Proceeds from exercise of stock options for cash (in shares)	82,355
Issuance of restricted stock units	$ 130	403,811			403,941
Issuance of restricted stock units (in shares)	130,091
Other comprehensive income (loss): foreign translation adjustment			654,792		654,792
Net loss				(22,672,487)	(22,672,487)
Balance at Sep. 30, 2023	$ 44,439	292,153,561	2,983,987	(276,670,365)	18,511,622
Balance (in shares) at Sep. 30, 2023	44,438,509
Balance at Dec. 31, 2022	$ 43,635	287,000,021	2,329,195	(253,997,878)	35,374,973
Balance (in shares) at Dec. 31, 2022	43,635,715
Balance at Dec. 31, 2023	$ 54,240	305,196,874	529,321	(282,505,272)	23,275,163
Balance (in shares) at Dec. 31, 2023	54,240,265
Balance at Jun. 30, 2023	$ 44,193	290,199,035	1,328,313	(267,476,845)	24,094,696
Balance (in shares) at Jun. 30, 2023	44,193,696
Stock-based compensation - employees, consultants and directors		1,086,163			1,086,163
Issuance of common stock offerings, net of fees	$ 162	632,232			632,394
Issuance of common stock offerings, net of fees (in shares)	162,078
Proceeds from exercise of stock options for cash	$ 9	15,920			15,929
Proceeds from exercise of stock options for cash (in shares)	7,962
Issuance of restricted stock units	$ 75	220,211			220,286
Issuance of restricted stock units (in shares)	74,773
Other comprehensive income (loss): foreign translation adjustment			1,655,674		1,655,674
Net loss				(9,193,520)	(9,193,520)
Balance at Sep. 30, 2023	$ 44,439	292,153,561	2,983,987	(276,670,365)	18,511,622
Balance (in shares) at Sep. 30, 2023	44,438,509
Balance at Dec. 31, 2023	$ 54,240	305,196,874	529,321	(282,505,272)	23,275,163
Balance (in shares) at Dec. 31, 2023	54,240,265
Stock-based compensation - employees, consultants and directors		2,344,671			2,344,671
Warrants issued in connection with long-term debt		690,709			690,709
Issuance of common stock offerings, net of fees	$ 53	11,741			11,794
Issuance of common stock offerings, net of fees (in shares)	53,290
Issuance of restricted stock units	$ 205	197,892			198,097
Issuance of restricted stock units (in shares)	207,058
Other comprehensive income (loss): foreign translation adjustment			(686,246)		(686,246)
Net loss				(12,835,098)	(12,835,098)
Balance at Sep. 30, 2024	$ 54,498	308,441,887	(156,925)	(295,340,370)	12,999,090
Balance (in shares) at Sep. 30, 2024	54,500,613
Balance at Jun. 30, 2024	$ 54,306	307,514,758	2,173,818	(293,006,279)	16,736,603
Balance (in shares) at Jun. 30, 2024	54,306,415
Stock-based compensation - employees, consultants and directors		781,881			781,881
ATM fee		(41,444)			(41,444)
Issuance of restricted stock units	$ 192	186,692			186,884
Issuance of restricted stock units (in shares)	194,198
Other comprehensive income (loss): foreign translation adjustment			(2,330,743)		(2,330,743)
Net loss				(2,334,091)	(2,334,091)
Balance at Sep. 30, 2024	$ 54,498	$ 308,441,887	$ (156,925)	$ (295,340,370)	$ 12,999,090
Balance (in shares) at Sep. 30, 2024	54,500,613

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Cash flows from operating activities:
Net loss	$ (12,835,098)	$ (22,672,487)
Adjustments to reconcile net loss to net cash used in operating activities:
Accrued final fee	111,422	32,143
Amortization of debt discount	132,351
Amortization of loan costs	58,014
Non-cash compensation	(96,268)	160,999
Depreciation and amortization	1,180,717	1,067,797
Amortization of right-of-use asset	137,780	166,321
Write off of patent cost	313,414	475,621
Bad debt expense	107,272	14,459
Stock-based compensation	2,344,671	2,486,679
Foreign currency translation (gain) loss	(680,392)	733,997
Changes in operating assets and liabilities:
Grants and accounts receivable	(628,510)	(603,286)
Inventories	429,004	471,822
Prepaid expenses and other current assets	504,530	1,370,510
Other assets	1,135
Accounts payable and accrued expenses	(3,165,684)	1,047,700
Net cash used in operating activities	(12,085,642)	(15,247,725)
Cash flows from investing activities:
Purchases of property and equipment	(215,158)	(442,618)
Payments for patent costs	(330,079)	(357,696)
Net cash used in investing activities	(545,237)	(800,314)
Cash flows from financing activities:
Proceeds from long-term debt	15,000,000
Repayment of long-term debt	(5,000,000)
Payment of final fee	(150,000)
Payment of loan costs	(697,950)
Equity contributions - net of fees incurred	11,794	2,050,417
Proceeds from exercise of stock options		213,307
Net cash provided by financing activities	9,163,844	2,263,724
Effect of exchange rates on cash	21,226	(1,205)
Net change in cash, cash equivalents and restricted cash	(3,445,809)	(13,785,520)
Cash, cash equivalents and restricted cash - beginning of period	15,615,095	23,832,026
Cash, cash equivalents and restricted cash - end of period	12,169,286	10,046,506
Supplemental disclosure of cash flow information:
Cash paid during the period for interest	771,875	275,575
Supplemental disclosure of non-cash financing activities:
Warrants issued in connection with long-term debt	690,709
Issuance of restricted stock units	$ 198,097	$ 403,941

BASIS OF PRESENTATION

BASIS OF PRESENTATION	9 Months Ended
	Sep. 30, 2024
BASIS OF PRESENTATION
BASIS OF PRESENTATION	1. BASIS OF PRESENTATION The accompanying unaudited condensed consolidated financial statements include the accounts of the Company as of September 30, 2024 and December 31, 2023, and for the three and nine months ended September 30, 2024 and 2023. The Company’s condensed consolidated financial statements have been prepared in accordance with the instructions to Form 10-Q and Rule 10-01 of Regulation S-X, and; therefore, do not include all information and footnotes necessary for a fair presentation of consolidated financial position, results of operations, and cash flows in conformity with accounting principles generally accepted in the United States ("U.S. GAAP") and should be read in conjunction with the audited consolidated financial statements of the Company for the year ended December 31, 2023, which are included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023. In the opinion of management, the Company has made all necessary adjustments, which include normal recurring adjustments, for a fair presentation of the Company’s consolidated financial position and results of operations for the interim periods presented. Certain information and disclosures normally included in the annual consolidated financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. The results for the three and nine months ended September 30, 2024 and 2023, are not necessarily indicative of the results to be expected for a full year, any other interim periods or any future year or period. As of September 30, 2024, the Company’s cash, cash equivalents and restricted cash balances were approximately $12.2 million, including approximately $5.7 million in cash and cash equivalents and approximately $6.5 million in restricted cash, of which the unrestricted portion is not expected to fund the Company’s operations beyond the next twelve months from the issuance of these consolidated financial statements. This matter raises substantial doubt about the Company’s ability to continue as a going concern. As a result, 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. The Company continues to pursue additional milestones related to its recently announced Avenue Capital Group debt facility that would increase its unrestricted cash position by up to $10 million. If these milestones are not achieved, the Company will need to raise additional capital to support our ongoing operations in the future. Meanwhile the Company continues to evaluate other traditional and alternative sources of capital, including additional less or non-dilutive debt financing, royalty financing, strategic or direct investments, equity financing, and/or combinations thereof. There can be no assurance that management will be successful in these endeavors.

PRINCIPAL BUSINESS ACTIVITY AND

PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	9 Months Ended
	Sep. 30, 2024
PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	2. PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Please see Note 2 to the Company's consolidated financial statements included in the Company's Annual Report on Form 10 - K for the year ended December 31, 2023, filed with the Securities and Exchange Commission ("SEC") on March 14, 2024, for a description of all significant accounting policies. Nature of Business The Company is a leader in the treatment of life-threatening conditions in intensive care and cardiac surgery using blood purification. 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 CytoSorb device. 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. 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 of America dollar the foreign currency financial statements of the European subsidiary, for which the United States of America dollar is the functional currency, are included in operations. The Euro is the functional currency of the European Subsidiary. Foreign currency transaction gain (loss) included in net loss amounted to approximately $2,650,000 and $(1,810,000) for the three months ended September 30, 2024 and 2023, respectively. Foreign currency transaction gain (loss) included in net loss amounted to approximately $680,000 and $(734,000) for the nine months ended September 30, 2024 and 2023, respectively. The Company translates assets and liabilities of all of its foreign subsidiaries at the exchange rate in effect at the condensed consolidated 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, Cash Equivalents and Restricted Cash The Company considers all highly liquid investments purchased with an original maturity of three months or less to be cash equivalents. The following table provides a reconciliation of cash and cash equivalents and restricted cash to amounts shown in the consolidated balance sheets: ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2024 December 31, 2023 Cash and cash equivalents ​ $ 5,685,328 ​ $ 14,131,137 Restricted cash ​ 6,483,958 ​ 1,483,958 Total cash, cash equivalents and restricted cash ​ $ 12,169,286 ​ $ 15,615,095 ​ Restricted Cash The Company’s total restricted cash in the amount of $6,483,958 consists of cash of $5,000,000 which is restricted in accordance with the terms of the debt agreement with Avenue Capital Group (see Note 5), cash of $1,467,458 that the Company is obligated to maintain as collateral for the outstanding letter of credit with Bridge Bank that was provided to the landlord of the College Road facility as security and cash of $16,500 that the Company is obligated to maintain as collateral for the credit limit on the Company’s credit card accounts. Grants and Accounts Receivable Trade accounts receivable consist of amounts due from direct customers, distributors and agencies of the U.S. government and are presented at net realizable value. At each balance sheet date, the Company estimates an expected allowance for credit losses inherent in the Company’s accounts receivable portfolio based on historical experience, specific allowances for known troubled accounts, and other available evidence. In addition, also at each reporting date, this estimate is updated to reflect any changes in credit risk since the receivable was initially recorded. This estimate is calculated on a pooled basis where similar risk characteristics exist. The Company has identified the following portfolio segments: direct customers, distributors/strategic partners and the U.S. government. A fixed reserve percentage for each pool is derived from a review of the Company’s historical losses in relation to the total pool. This estimate is adjusted quarterly for management’s assessment of current conditions, reasonable and supportable forecasts regarding future events, and any other factors deemed relevant by the Company. The Company believes historical loss information is a reasonable starting point in which to calculate the expected allowance for credit losses as the Company’s portfolio segments have remained constant over the Company’s historical evaluation period. The Company writes off receivables when there is information that indicates the debtor is facing significant financial difficulty and there is no possibility of recovery. If any recoveries are made from any accounts previously written off, they are recognized as an offset to credit loss expense in the year of recovery. The total amount of write-offs was immaterial to the consolidated financial statements as a whole for the three and nine months ended September 30, 2024 and 2023. The allowance for credit losses reflects accounts receivable balances that are written off when management determines they are uncollectible. The allowance for credit losses is measured on a collective (pool) basis when similar risk characteristics exist, and measures the allowance for credit losses using the following methods: Direct Customers—The Company measures expected credit losses on direct customer receivables using an aging methodology. The risk of loss for direct customer receivables is low based on the Company’s historical experience. The estimate of expected credit losses considers historical credit loss information that is adjusted for current conditions and supportable forecasts. Distributors/Strategic Partners—The Company measures expected credit losses on distributor receivables using an individual reserve methodology. The risk of loss in this portfolio is low based on the Company’s historical experience. The estimate of expected credit losses considers the past payment history of each distributor. U.S. Government— These receivables are related to the Company’s government grants. The Company measures expected credit losses on these receivables using an individual reserve methodology. The risk of loss in this portfolio is very low based on the Company’s historical experience, as these receivables are supported by approved grant award contracts. Inventories Inventories are valued at the lower of cost or net realizable value under the first in, first out (FIFO) method. At September 30, 2024 and December 31, 2023, the Company’s inventory was comprised of finished goods, which amounted to $1,430,325 and $2,155,457, respectively; work in process, which amounted to $1,049,319 and $838,871, respectively; and raw materials, which amounted to $768,112 and $685,801, 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. Donated devices are removed from inventory and charged to selling, general and administrative expenses. 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. During the three months ended September 30, 2024 and 2023, the Company recorded impairment charges of approximately $64,000 and $183,000, respectively, and during the nine months ended September 30, 2024 and 2023, the Company recorded impairment charges of approximately $313,000 and $476,000, respectively, related to the impairment of certain issued patents and pending patent applications in certain specific jurisdictions and the abandonment of certain pending patent application costs in the ordinary course of business. This charge is included in legal, financial and other consulting in the consolidated statements of operations and comprehensive loss. Income Taxes The Company has not recorded income tax expense or income tax benefit for the three and nine months ended September 30, 2024, and 2023 due to the generation of net operating losses, the benefits of which have been fully reserved. Deferred income taxes are accounted for using the balance sheet approach, which requires recognition of deferred tax assets and liabilities for the expected future consequences of temporary differences between the financial reporting basis and the tax basis of assets and liabilities. A valuation allowance is provided when it is more likely than not that a deferred tax asset will not be realized. A full valuation allowance has been established on the deferred tax asset as it is more likely than not that a future tax benefit will not be realized. In addition, future utilization of the available net operating loss carryforward may be limited under Internal Revenue Code Section 382 as a result of changes in ownership. The Company follows accounting standards associated with uncertain tax positions. The Company had no unrecognized tax benefits at September 30, 2024. The Company is accounting for an uncertain tax position of approximately $2.1 million for the year ended December 31, 2023. 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 carryforwards to an industrial company. 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 (“FDIC”). Beginning in April of 2023, the Company joined the IntraFi network, and established an Insured Cash Sweep (“ICS”) account whereby all cash that was previously held in the Company’s money market account at Bridge Bank is swept daily in increments of less than $250,000 and deposited in a number of IntraFi’s 4,000 member banks. This arrangement provides FDIC insurance coverage for all of the cash balances previously held in the money market account, which represents all of the cash and cash equivalents held at Bridge Bank. This arrangement excludes the restricted cash balances. Management monitors the soundness of these institutions in an effort to minimize its collection risk of these balances. A significant portion of the Company’s revenues are from product sales in Germany. Substantially all of the Company’s grant and other income are from government agencies in the United States. (See Note 4 for further information relating to the Company’s revenue.) As of September 30, 2024, two distributors accounted for approximately 31% of outstanding grants and accounts receivable. As of December 31, 2023, one distributor accounted for approximately 19% of outstanding grants and accounts receivable. For the three months ended September 30, 2024 and 2023, no distributor or direct customers accounted for more than 10% of the Company’s total revenue. For the nine months ended September 30, 2024 and 2023, one distributor accounted for approximately 10% for each period, of the Company’s total revenue. Warrants The Company accounts for warrants as either equity-classified or liability-classified instruments based on an assessment of the warrant’s specific terms and applicable authoritative guidance in ASC 480 “Distinguishing Liabilities From Equity” (“ASC 480”) and ASC 815 “Derivatives and Hedging” (“ASC 815”). The assessment considers whether the warrants are freestanding financial instruments pursuant to ASC 480, meet the definition of a liability pursuant to ASC 480, and whether the warrants meet all of the requirements for equity classification under ASC 815, including whether the warrants are indexed to the Company’s own ordinary shares and whether the warrant holders could potentially require “net cash settlement” in a circumstance outside of the Company’s control, among other conditions for equity classification. This assessment, which requires the use of professional judgment, is conducted at the time of warrant issuance and as of each subsequent quarterly period end date while the warrants are outstanding. For issued or modified warrants that meet all of the criteria for equity classification, the warrants are required to be recorded as a component of equity at the time of issuance, and will remain as a component of equity thereafter. For issued or modified warrants that do not meet all the criteria for equity classification, the warrants are required to be recorded as liabilities at their initial fair value on the date of issuance, and each balance sheet date thereafter. Changes in the estimated fair value of the warrants are recognized as a non-cash gain or loss on the statements of operations. The warrants issued upon the closing of the Company’s December 13, 2023 offering and the closing of the Company’s June 2024 debt financing both met the criteria for equity classification under ASC 815. Accordingly, these warrants have been classified as equity as of September 30, 2024 and December 31, 2023. 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 $89,000 and $140,000, respectively, for the three months ended September 30, 2024 and 2023, and $267,000 and $341,000, respectively, for the nine months ended September 30, 2024 and 2023. Effect of Recent Accounting Pronouncements In August 2020, the FASB issued ASU 2020-06, “Debt – Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging – Contracts in Entity’s Own Equity (Subtopic 815-40)” (“ASU 2020-06”). ASU2020-06 simplifies the accounting for certain financial instruments with characteristics of liabilities and equity, including convertible instruments and contracts on an entity’s own equity. The ASU is part of the FASB’s simplification initiative, which aims to reduce unnecessary complexity in U.S. GAAP. The ASU’s amendments are effective for fiscal years beginning after December 15, 2024, and interim periods within those fiscal years. The Company adopted the provisions of ASU 2020-06 on January 1, 2024. This did not have a material impact on the Company’s consolidated financial statements. In December 2023, the FASB issued ASU No. 2023-09 entitled “Income Taxes (Topic 740): Improvements to Income Tax Disclosures”. This ASU provides guidance related to additional disclosures that will be required related to income taxes. The updated guidance is effective for public entities for fiscal years beginning after December 15, 2024. This ASU will result in additional disclosures in the Company’s consolidated financial statements related to income taxes in 2025. In November 2023, the FASB issued ASU No. 2023-07 (“ASU 2023-07”), “Improvements to Reportable Segment Disclosures”. The guidance primarily will require enhanced disclosures about significant segment expenses. All disclosure requirements under ASU 2023-07 and existing segment disclosures in ASC 280, “Segment Reporting” are also required for public entities with a single reportable segment. The amendments in ASU 2023-07 are effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. A retrospective approach is required to be applied to all prior periods presented in the financial statements. The Company plans to adopt the provisions of ASU 2023-07 in the first quarter of fiscal 2025 and continues to evaluate the disclosure requirements related to the new standard. On April 3, 2024, the Financial Accounting Standards Board (the "FASB") began a project related to the accounting and reporting of government grants. The FASB has decided to pursue an International Accounting Standards ("IAS") 20 accounting model. Under IAS 20, a grant relating to income may be reported separately as 'other income' or deducted from the related expense. The FASB expects to issue and exposure draft of a proposed ASU in the fourth quarter of 2024. The company is evaluating its accounting and reporting policy for government grants relative to this project and the requirements of IAS 20.

STOCKHOLDERS' EQUITY

STOCKHOLDERS' EQUITY	9 Months Ended
	Sep. 30, 2024
STOCKHOLDERS' EQUITY
STOCKHOLDERS' EQUITY	3. STOCKHOLDERS’ EQUITY Preferred Stock In June 2019, the Company amended and restated its certificate of incorporation. 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 In June 2019, the Company amended and restated its certificate of incorporation. The amended and restated certificate of incorporation increased the number of shares of common stock authorized for issuance from 50,000,000 shares to 100,000,000 shares. Shelf Registration On July 14, 2021, the Company filed a registration statement on Form S-3 with the SEC, which was amended on July 20, 2021 and declared effective by the SEC on July 27, 2021 (as amended, the “2021 Shelf”). The 2021 Shelf 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 and expires after three years. On July 26, 2024, the Company filed a registration statement on Form S-3 with the SEC (the “2024 Shelf”), which 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. On September 26, 2024, the Company filed Amendment No. 1 to the Form S-3 with the SEC. The 2024 Shelf was declared effective by the SEC on September 30, 2024. Because the Company’s market capitalization is less than $75 million, it will be subject to baby shelf rules which limit the amount of securities sales the Company can make to one-third of its public market float over a 12-month period. Open Market Sale Agreement with Jefferies LLC On December 30, 2021, the Company entered into an Open Market Sale Agreement (the “Sale Agreement”) with Jefferies LLC (the “Agent”), pursuant to which the Company may sell, from time to time, at its option, shares of the Company’s common stock having an aggregate offering price of up to $25 million through the Agent, as the Company’s sales agent. However, as a result of limitations related to our market capitalization discussed above, the Company may offer and sell shares of the Company's common stock having an aggregate offering price of up to approximately $19,700,000 from time to time through the Agent. If the Company's public float increases above $75,000,000, the Company may sell additional amounts under the Sales Agreement. All shares of the Company’s common stock offered and sold, or to be offered and sold under the Sale Agreement will be issued and sold pursuant to the Company’s 2024 Shelf by methods deemed to be an “at the market offering” as defined in Rule 415(a)(4) promulgated under the Securities Act of 1933, as amended, in block transactions or if specified by the Company, in privately negotiated transactions. Subject to the terms of the Sales Agreement, the Agent is required to use its commercially reasonable efforts consistent with their normal sales and trading practices to sell the shares of the Company’s common stock from time to time, based upon the Company’s instructions (including any price, time or size limits or other customary parameters or conditions the Company may impose). The Company is required to pay the Agent a commission of up to 3.0% of the gross proceeds from the sale of the shares of the Company’s common stock sold thereunder, if any. There were no sales under the Sale Agreement during the year ended December 31, 2022. During the year ended December 31, 2023, the Company sold 2,656,464 shares pursuant to the Sale Agreement, at an average selling price of $1.76 per share, generating net proceeds of approximately $4,532,000. In addition, during the year ended December 31, 2023, the Company paid approximately $61,000 in expenses related to the Sale Agreement. During the nine months ended September 30, 2024, the Company sold 53,290 shares pursuant to the Sales Agreement at an average selling price of $1.03 per share, generating net proceeds of approximately $53,000. In addition, the Company incurred ATM activation fees of approximately $41,000 during the three and nine months ended September 30, 2024. Stock-Based Compensation Total share-based employee, director, and consultant compensation amounted to approximately $782,000 and $2,345,000 for the three and nine months ended September 30, 2024, respectively, and approximately $1,086,000 and $2,487,000 for the three and nine months ended September 30, 2023, respectively. These amounts are included in the consolidated statements of operations and comprehensive loss under cost of revenue and selling, general, and administrative expenses. The summary of the stock option activity for the nine months ended September 30, 2024 is as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted ​ ​ ​ ​ Weighted ​ Average ​ ​ ​ ​ Average ​ Remaining ​ ​ ​ ​ Exercise Price ​ Contractual ​ Shares per Share Life (Years) Outstanding, December 31, 2023 10,548,174 ​ $ 4.49 ​ 7.01 Granted 3,687,366 ​ $ 0.96 — Forfeited (1,018,794) ​ $ 2.69 — Expired (706,609) ​ $ 5.40 — Exercised — ​ $ — — Outstanding, September 30, 2024 12,510,137 ​ $ 3.54 7.06 ​ 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 $0.84 to $1.08 per share) and expected life of the stock option (6 years), the current price of the underlying stock and its expected volatility (77.8%), expected dividends (0)% on the stock and the risk free interest rate (ranging from 3.60% to 4.65%) for the expected term of the stock option. The intrinsic value is calculated as the difference between the market value of the shares as of September 30, 2024 of $1.50 and the exercise price of the shares. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Options Outstanding ​ ​ Number ​ Weighted ​ Weighted ​ ​ ​ Range of ​ Outstanding at ​ Average ​ Average ​ Aggregate Exercise ​ September 30, ​ Exercise ​ Remaining ​ Intrinsic Price 2024 Price Life (Years) Value $0.84 - $13.20 12,510,137 ​ $ 3.54 ​ 7.06 ​ $ 1,892,822 ​ ​ ​ ​ ​ ​ ​ ​ Options Exercisable Number ​ Weighted ​ Exercisable at ​ Average ​ Aggregate September 30, ​ Exercise ​ Intrinsic 2024 Price Value 6,164,466 ​ $ 5.48 ​ $ 33,555 ​ The summary of the status of the Company’s non-vested options for the nine months ended September 30, 2024 is as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted ​ ​ ​ ​ Average ​ ​ ​ ​ Grant Date ​ Shares Fair Value ​ ​ ​ ​ ​ ​ Non-vested, December 31, 2023 5,205,736 ​ $ 1.89 Granted 3,687,366 ​ $ 0.67 Forfeited (1,018,794) ​ $ 1.81 Vested (1,528,637) ​ $ 2.30 Non-vested, September 30, 2024 6,345,671 ​ $ 1.08 ​ As of September 30, 2024, the Company had approximately $3,540,000 of total unrecognized compensation cost related to stock options which will be amortized over approximately 35 months. On March 29, 2024, the Company granted options to purchase 380,480 shares of common stock to certain executive officers and certain other non-executive officer employees related to the Company’s salary reduction for stock options program. These options will vest in full on January 31, 2025. The grant date fair value of these unvested options amounted to approximately $249,000. On April 2, 2024, the Company granted options to purchase 1,214,400 shares of common stock to the Company’s employees which will be awarded based upon each employee’s 2024 individual performance evaluation. Once awarded, these options will vest one one one On April 2, 2024, the Company granted options to purchase 922,147 shares of common stock to certain of the Company’s employees. These options will vest in full on the first anniversary of the grant date. The grant date fair value of these unvested options amounted to approximately $594,000. On April 2, 2024, the Company granted options to purchase 110,000 shares of common stock to members of the Company’s Board of Directors. These options will vest in full on the first anniversary of the grant date. The grant date fair value of these unvested options amounted to approximately $71,000. On April 2, 2024, the Company granted options to purchase 556,000 shares of common stock to certain senior managers of the Company. These options will vest one one one On April 8, 2024, the Company granted options to purchase 131,339 shares of common stock employees related to the Company’s salary reduction for stock options program. The grant date fair value of these unvested options amounted to approximately $85,000. These options will vest in full on January 31, 2025. On August 14, 2024, the Company granted, in connection with the appointment of its new Chief Financial Officer, options to purchase 80,000 shares of common stock which will vest as follows: 41,000 options upon the six - month anniversary of the date of grant and 13,000 options upon each of the first, second and third anniversaries of the date of grant. The Company also granted options to purchase 215,000 shares of common stock that will vest only upon the achievement of certain milestones pursuant to the terms of the Company's existing 2022 - 2025 performance pool in place for the Company's management team. During the nine months ended September 30, 2024, 78,000 options were awarded to newly hired employees or to consultants in connection with their employment or consulting agreements. 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 Amended and Restated CytoSorbents Corporation 2014 Long-Term Incentive Plan, as amended. 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, 2023 346,500 779,500 1,697,500 2,823,500 $ 3,134,085 Granted — 175,000 156,250 331,250 ​ ​ Forfeited — — (330,750) (330,750) ​ ​ September 30, 2024 346,500 954,500 1,523,000 2,824,000 ​ $ 4,236,000 ​ 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 statements of operations and comprehensive loss for the three and nine months ended September 30, 2024 and 2023. Other Awards of Restricted Stock Units: On August 10, 2022, certain named executive officers and senior managers were granted 288,500 restricted stock units. These awards were valued at approximately $563,000 at the date of issuance, based upon the market price of the Company’s common stock at the date of the grant, and vested (or will 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 and nine months ended September 30, 2024 and 2023, the Company recorded a charge (income) of approximately $(67,000) and $27,000, and $106,000 and $214,000, respectively, related to these restricted stock unit awards. On July 7, 2023, certain named executive officers and senior managers were granted 250,000 restricted stock units. These awards were valued at approximately $883,000 at the date of issuance, based upon the market price of the Company’s common stock at the date of the grant, and will vest two-thirds on the first anniversary of date of the grant, and one-third on the second anniversary of the date of the grant. For the three and nine months ended September 30, 2024 and 2023, the Company recorded a charge (income) of approximately $(234,000) and $(13,000) and $102,000 and $0, respectively, related to these restricted stock unit awards. On September 18, 2023, a former named executive officer was granted 45,000 restricted stock units. This award was valued at approximately $89,000 at the date of issuance, based upon the market price of the Company’s common stock at the date of the grant. These restricted stock units vested (will vest) as follows: 25,000 on the date of the grant, 10,000 on the first anniversary of the date of the grant and 10,000 on the second anniversary of the date of the grant. For the three and nine months ended September 30, 2024 and 2023, the Company recorded a charge (income) of approximately $(1,000) and $9,000 and $50,000 and $0, respectively, related to these restricted stock unit awards. On April 2, 2024, the Board of Directors granted 343,000 restricted stock units to certain senior managers of the Company. These awards were valued at approximately $328,000 at the date of issuance, based upon the market price of the Company’s common stock at the date of the grant, and will vest one half on the first anniversary of the grant date and one half on the second anniversary of the grant date. For the three and nine months ended September 30, 2024 and 2023, the Company recorded a charge of approximately $41,000 and $81,000 and $0 and $0, respectively, related to these restricted stock unit awards. On August 14, 2024, the Company granted, in connection with the appointment of its new Chief Financial Officer, 65,000 restricted stock units. This award was valued at approximately $63,000 at the date of issuance, based upon the market price of the Company's common stock at the date of the grant. These restricted stock units will vest equally on the first anniversary of the date of the grant and the second anniversary of the date of the grant. For the three and nine months ended September 30, 2024 and 2023, the Company recorded a charge of approximately $4,000 and $4,000 and $0 and $0, respectively, related to these restricted stock unit awards. Additionally, certain employees were offered a total of 213,000 restricted stock units as a condition of their employment. These awards were valued at approximately $517,000 at the date of issuance. 40,000 of these restricted stock units valued at $149,000 were forfeited as of September 30, 2024. 33,000 of these restricted stock units valued at approximately $231,000 were vested as of September 30, 2024. The remaining 140,000 of these restricted stock units will vest upon the earlier of a Change in Control or in three The following table outlines the restricted stock unit activity for the nine months ended September 30, 2024: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted ​ ​ ​ ​ Average ​ ​ ​ ​ Grant Date ​ Shares Fair Value Non-vested, December 31, 2023 430,505 ​ $ 3.31 Granted ​ 548,000 ​ $ 0.96 Vested (297,169) ​ $ 3.23 Forfeited ​ (40,000) ​ $ 3.73 Non-vested, September 30, 2024 ​ 641,336 ​ $ 1.31 ​ Warrants: As of September 30, 2024, the Company had 4,352,130 warrants outstanding. 2,706,561 warrants outstanding are related to the Company’s December 13, 2023 offering and these warrants are immediately cash exercisable at an exercise price of $2.00 per share and expire on December 13, 2028. Another 1,645,569 warrants were issued on June 28, 2024 in connection with the closing of the Company’s Loan and Security Agreement with Avenue Capital Group (see Note 5). These warrants have an exercise price of $0.79 and expire on June 28, 2029. The number of warrants is fixed, however, the exercise price may be adjusted down if the Company raises equity (excluding sales of equity utilizing the Company’s at-the-market equity facility) at a share price that is lower than $0.79. These warrants can be exercised into common stock.

REVENUE

REVENUE	9 Months Ended
	Sep. 30, 2024
REVENUE
REVENUE	4. REVENUE The following table disaggregates the Company’s revenue by customer type and geographic area for the three months ended September 30, 2024: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ ​ ​ ​ ​ ​ ​ ​ Distributors/ ​ Government ​ ​ ​ ​ Direct Strategic Partners Agencies Total Product sales: ​ ​ ​ ​ United States ​ $ 20,705 ​ $ — ​ $ — ​ $ 20,705 Germany ​ 3,180,863 ​ ​ — ​ ​ — ​ ​ 3,180,863 All other countries ​ 1,937,580 ​ ​ 3,473,647 ​ ​ — ​ ​ 5,411,227 Total product revenue ​ 5,139,148 ​ ​ 3,473,647 ​ ​ — ​ ​ 8,612,795 Grant and other income: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ — ​ ​ — ​ ​ 777,593 ​ ​ 777,593 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total revenue ​ $ 5,139,148 ​ $ 3,473,647 ​ $ 777,593 ​ $ 9,390,388 ​ The following table disaggregates the Company’s revenue by customer type and geographic area for the three months ended September 30, 2023: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ ​ ​ ​ ​ ​ ​ ​ Distributors/ ​ Government ​ ​ ​ ​ Direct Strategic Partners Agencies Total Product sales: ​ ​ ​ ​ United States ​ $ 44,933 ​ $ — ​ $ — ​ $ 44,933 Germany ​ 2,937,431 ​ ​ — ​ ​ — ​ ​ 2,937,431 All other countries ​ 1,267,051 ​ ​ 3,504,601 ​ ​ — ​ ​ 4,771,652 Total product revenue ​ 4,249,415 ​ ​ 3,504,601 ​ ​ — ​ ​ 7,754,016 Grant and other income: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ — ​ ​ — ​ ​ 1,056,831 ​ ​ 1,056,831 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total revenue ​ $ 4,249,415 ​ $ 3,504,601 ​ $ 1,056,831 ​ $ 8,810,847 ​ The following table disaggregates the Company’s revenue by customer type and geographic area for the nine months ended September 30, 2024: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ ​ ​ ​ ​ ​ ​ ​ Distributors/ ​ Government ​ ​ ​ ​ Direct Strategic Partners Agencies Total Product sales: ​ ​ ​ ​ United States ​ $ 62,719 ​ $ 36,000 ​ $ — ​ $ 98,719 Germany ​ 9,497,184 ​ ​ — ​ ​ — ​ ​ 9,497,184 All other countries ​ 5,361,933 ​ ​ 11,486,268 ​ ​ — ​ ​ 16,848,201 Total product revenue ​ 14,921,836 ​ ​ 11,522,268 ​ ​ — ​ ​ 26,444,104 Grant and other income: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ — ​ ​ — ​ ​ 2,627,212 ​ ​ 2,627,212 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total revenue ​ $ 14,921,836 ​ $ 11,522,268 ​ $ 2,627,212 ​ $ 29,071,316 ​ The following table disaggregates the Company’s revenue by customer type and geographic area for the nine months ended September 30, 2023: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ ​ ​ ​ ​ ​ ​ ​ Distributors/ ​ Government ​ ​ ​ ​ Direct Strategic Partners Agencies Total Product sales: ​ ​ ​ ​ United States ​ $ 55,284 ​ $ — ​ $ — ​ $ 55,284 Germany ​ 9,443,787 ​ ​ — ​ ​ — ​ ​ 9,443,787 All other countries ​ 4,263,375 ​ ​ 9,974,022 ​ ​ — ​ ​ 14,237,397 Total product revenue ​ 13,762,446 ​ ​ 9,974,022 ​ ​ — ​ ​ 23,736,468 Grant and other income: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ — ​ ​ — ​ ​ 3,944,696 ​ ​ 3,944,696 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total revenue ​ $ 13,762,446 ​ $ 9,974,022 ​ $ 3,944,696 ​ $ 27,681,164 ​ 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. 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. The majority of sales of the device are outside the United States, as CytoSorb is not yet approved for commercial sale in the United States. However, in April 2020, the Company was granted Emergency Use Authorization (“EUA”) of CytoSorb for use in critically-ill patients infected with COVID-19 with imminent or confirmed respiratory failure by the United States Food and Drug Administration (the “FDA”). Direct sales outside the United States relate to sales to hospitals located in Germany, Switzerland, Austria, Belgium, Luxembourg, Poland, the Netherlands, Sweden, Denmark, Norway and the United Kingdom. Direct sales are fulfilled from the Company’s warehouse facility in Berlin, Germany. 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 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 versus 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. Most distributor’s/strategic partner’s contracts have minimum annual purchase requirements in order to maintain exclusivity in their respective territories. There is no additional consideration or monetary penalty that would be required to be paid to CytoSorbents if a distributor does not meet the minimum purchase commitments included in the contract, however, at the discretion of the Company, the distributor may lose its exclusive rights in the territory if such commitments are not met. 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 contracts 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. If billings on fixed price contracts exceed the costs incurred, revenue will be deferred to the extent of the excess billings. 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 upon 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. 4. Performance based – the Company submits invoices only upon the achievement of the milestones listed in the contract. The amount to be invoiced for each milestone is documented in the contract. These government contracts have terms ranging from three months to four years. The Company may apply for an extension of the term of the contract in order to complete its research and development activities but would not receive additional funding during the extension period in excess of the original contract. See Note 2 regarding the accounting policies related to these contracts. The Company is evaluating the potential reclassification of grant income and related costs of goods sold to net with research and development expenses. 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: ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2024 December 31, 2023 Receivables, which are included in grants and accounts receivable ​ $ 4,845,233 ​ $ 3,846,271 Contract liabilities, which are included in accrued expenses and other current liabilities ​ $ 837,592 ​ $ 1,573,141 ​ Contract receivables represent balances due from product sales to distributors amounting to $4,528,972 and $3,270,724 at September 30, 2024 and December 31, 2023, respectively, and billed and unbilled amounts due on government contracts amounting to $316,261 and $575,547 at September 30, 2024 and December 31, 2023, respectively. Contract liabilities represent the value of free of charge goods and credit rebates earned in accordance with the terms of certain direct customer agreements, which amounted to $51,192 and $196,322 as of September 30, 2024 and December 31, 2023, respectively, and deferred grant revenue related to the billing on fixed price contracts in excess of costs incurred, which amounted to $786,400 and $1,376,819 at June 30, 2024 and December 31, 2023, respectively.

LONG-TERM DEBT, NET

LONG-TERM DEBT, NET	9 Months Ended
	Sep. 30, 2024
LONG-TERM DEBT, NET
LONG-TERM DEBT, NET	5. LONG-TERM DEBT, NET Avenue Capital Group: On June 28, 2024 (the “Closing Date”), the Company entered into a Loan and Security Agreement (as amended, supplemented, restated or otherwise modified as of the date hereof and from time to time, the “Loan and Security Agreement”) with Avenue Venture Opportunities Fund, L.P., a Delaware limited partnership (“Avenue”), Avenue Venture Opportunities Fund II, L.P., a Delaware limited partnership (“Avenue 2” and, together with Avenue, the “Lenders”), and Avenue Capital Management II, L.P., a Delaware limited partnership (the “Administrative and Collateral Agent”). Under the Loan and Security Agreement, the Lenders have agreed to loan to the Company up to an aggregate of $20 million, to be disbursed in two tranches: (1) one tranche of $15 million (“Growth Capital Loan Tranche 1”) on the Closing Date, with $4.5 million funded by Avenue and $10.5 million funded by Avenue 2, of which $10 million is available to the Company on the Closing Date and $5 million constitutes restricted cash subject to release to the Company prior to March 31, 2025, provided (i) the FDA has accepted Company’s application for review with respect to DrugSorb-ATR De Novo 510(k) and (ii) the Company has received a minimum of $3 million in net proceeds from the sale of its equity securities after the Closing Date. The restriction will be released on a dollar for dollar basis for equity raised between $3 million and $5 million and (2) a second tranche of up to $5 million, which may be disbursed at the Company’s request between July 1, 2025 and December 31, 2025, provided that the Company receives FDA marketing approval of its DrugSorb-ATR application (“Growth Capital Loan Tranche 2” and together with Growth Capital Loan Tranche 1, the “Growth Capital Loans” or the “Commitment”). The proceeds from the Commitment were used to pay off the existing outstanding debt with Bridge Bank, and will additionally be used for working capital purposes and to fund general business requirements in accordance with the terms of the Loan and Security Agreement. Each Growth Capital Loan shall bear interest at a variable rate per annum equal to the greater of (A) the Prime Rate Commencing on August 1, 2024, the Company shall make monthly payments during the term of each Growth Capital Loan of interest only during the initial 25-month period following the Closing Date (as may be extended to the 30 months anniversary of the Closing Date upon satisfaction of certain conditions) and thereafter to maturity in equal monthly installments of principal plus accrued and unpaid interest. All unpaid principal and accrued and unpaid interest shall be due and payable in full on July 1, 2027; provided, however that if the Company draws the full amount of Growth Capital Loan Tranche 2 by December 2025, all unpaid principal and accrued and unpaid interest shall be due and payable in full by January 1, 2028. In addition, the Loan and Security Agreement required the Company to pay a non-refundable commitment fee equal to 1.00% of the Commitment due and payable on the Closing Date. In addition to the non-refundable commitment fee, the Company also paid financial advisor fees and legal fees of approximately $640,000 related to the Commitment. These costs are being amortized over the loan period as a charge to interest expense. During the three and nine months ended September 30, 2024, the Company recorded interest expense of approximately $58,000 related to these costs. In addition, the Loan and Security Agreement requires the Company to pay a non-refundable final payment equal to 4.5% of the original commitment amount. This final payment has been accrued and included as part of the debt discount. This discount will be charged to interest expense over the term of the loan. For the three and nine months ended September 30, 2024, the Company recorded interest expense of approximately $132,000 related to the debt discount. The Capital Growth Loans are evidenced by secured promissory notes issued to the Lenders by the Company. If the Company elects to prepay the Growth Capital Loan(s) pursuant to the terms of the Loan and Security Agreement, it will owe a prepayment fee to the Lenders, as follows: (1) for a prepayment made on or after the funding date of a Growth Capital Loan through and including the first anniversary of such funding date, an amount equal to 3.00% of the principal amount of such Growth Capital Loan prepaid; (2) for a prepayment made after the first anniversary of the funding date of a Growth Capital Loan through and including the second anniversary of such funding date, an amount equal to 2.00% of the principal amount of such Growth Capital Loan prepaid; and (3) for a prepayment made any time after the second anniversary of the funding date of a Growth Capital Loan, an amount equal to 1.00% of the principal amount of such Growth Capital Loan prepaid. Events of default which may cause repayment of the Commitment 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 Loan and Security Agreement and to cure such default within a reasonable time frame, (3) the occurrence of any circumstance that has a Material Adverse Effect (as defined in the Loan and Security Agreement), (4) default beyond any applicable grace period or cure under any other agreement involving the borrowing of money in excess of the Threshold Amount (as defined in the Loan and Security Agreement), (5) any judgment(s) singly or in the aggregate in excess of the Threshold Amount entered against the Company that remain unsatisfied, unvacated or unstayed for 15 days or more after entry thereof (to the extent not otherwise covered by independent third-party insurance), and (6) if the Company becomes insolvent or starts an insolvency proceeding or if an insolvency proceeding is brought by a third party against the Company and such proceeding is not dismissed or stayed within 45 days. The Loan and Security Agreement includes customary loan conditions, company representations and warranties, company affirmative covenants and company negative covenants for secured transactions of this type. As of September 30, 2024, the Company was in compliance with these covenants. As additional consideration for the Commitment, on June 28, 2024, the Company also issued each Lender a warrant instrument (each, a “Warrant”) entitling the Lenders to purchase an aggregate of 1,645,569 shares of the Company’s common stock for cash at the exercise price of $0.79 and expire on June 28, 2029. The number of warrants is fixed, however, the exercise price may be adjusted down if the Company raises equity (excluding sales of equity utilizing the Company’s at-the-market equity facility) at a share price that is lower than $0.79. These warrants meet the criteria for equity classification under ASC 815. Accordingly, the Company has recorded a debt discount and additional paid-in capital of approximately $690,000 The Lenders were also granted the right while the Commitment is outstanding to convert up to an aggregate amount of $2,000,000 of the principal amount of the outstanding Growth Capital Loans into the Company’s common stock at a fixed conversion price of 120% of the Closing Price (as defined in the warrant) or $0.95 per share (the “Conversion Option”). The Company’s and CytoSorbents Medical’s obligations under the Loan and Security Agreement are joint and several. The obligations under the Loan and Security Agreement are secured by a first priority security interest in favor of the Lenders with respect to the Company’s Shares (as defined in the Loan and Security Agreement) and the Company’s Collateral (as defined in the Loan and Security Agreement), which includes the Company’s intellectual property, pursuant to that certain Intellectual Property Security Agreement, dated as of June 28, 2024, by and between the Company and the Administrative and Collateral Agent. ​ Long-term debt consists of the following as of September 30, 2024: ​ ​ ​ ​ Principal amount $ 15,000,000 Accrued final fee ​ 900,000 Less unamortized debt discount ​ ​ (1,455,858) Less unamortized debt acquisition costs ​ ​ (638,157) Subtotal ​ 13,805,985 Less Current maturities ​ — Long-term debt net of current maturities ​ $ 13,805,985 ​ Principal payments of long-term debt are due as follows during the periods ending September 30: ​ ​ ​ ​ 2025 $ — 2026 ​ 2,500,000 2027 ​ 12,500,000 2028 ​ ​ — Total ​ $ 15,000,000 ​ Bridge Bank: On June 28, 2024, concurrent with the closing of the Avenue Capital Group financing discussed above, the Company paid off its existing outstanding debt with Bridge Bank. The following items survive the termination of the Bridge Bank Amended and Restated Loan and Security Agreement and related amendments: 2018 Success Fee Letter: Pursuant to the amended 2018 Letter, the Borrower shall pay to the Bank a success fee in the amount equal to 6.37% of the funded amount of the Term B Loan (as defined in the Restated Loan and Security Agreement) (the “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 the Nasdaq Capital Market being the greater of (i) 70% or more over $7.05, the closing price of the Company’s common stock on March 29, 2018 (after giving effect to any stock splits or consolidations effected after the date thereof) for five 2022 Success Fee Letter: Pursuant to the 2022 Success Fee Letter, the Borrower will pay to the Bank a success fee equal to (i) 1% of $5 million if the Company draws down the first tranche of the Term C Loan and is payable only if the Company’s stock price equals or exceeds $8 for five five five

COMMITMENTS AND CONTINGENCIES

COMMITMENTS AND CONTINGENCIES	9 Months Ended
	Sep. 30, 2024
COMMITMENTS AND CONTINGENCIES
COMMITMENTS AND CONTINGENCIES	6. COMMITMENTS AND CONTINGENCIES Litigation The Company is, from time to time, subject to claims and litigation arising in the ordinary course of business. The Company intends to defend vigorously against any future claims and litigation. On March 5, 2024, Danielle Greene, a former employee, filed a complaint against us in the Superior Court of New Jersey, Law Division, Mercer County, alleging breach of the New Jersey Conscientious Employee Protection Act (“CEPA”). The complaint specifically alleges that we violated the provisions of the CEPA by allegedly terminating Ms. Greene in retaliation for complaining about certain business practices. We dispute these allegations and intend to vigorously defend against them, but there can be no assurance as to the outcome of the litigation. Royalty/License Agreements The Company is party to various royalty and license agreements that require the payment of royalty fees. Royalty expense amounted to approximately $354,000 and $537,000, respectively, for the three months ended September 30, 2024 and 2023. For the nine months ended September 30, 2024 and 2023, royalty expense amounted to approximately $1,594,000 and $1,643,000, respectively. In addition, the Company’s license agreement with Purolite expired on August 6, 2024. Royalty expense are included in selling, general and administrative expenses in the consolidated statements of operations and comprehensive loss.

LEASES

LEASES	9 Months Ended
	Sep. 30, 2024
LEASES
LEASES	7. LEASES The Company leases its operating facilities in both the United States and Germany under operating lease agreements. In March 2021, CytoSorbents Medical Inc. entered into a lease agreement for a new operating facility at 305 College Road East, Princeton, New Jersey, which contains office, laboratory, manufacturing and warehouse space. The lease commenced on June 1, 2021. The Early Term commenced on June 1, 2021 and ended September 30, 2021. The lease also contains two five-year renewal options; however, the Company had determined that it is not likely that they will exercise these options. Commencing on September 30, 2021, the remaining lease term will end in 15.5 years. The lease requires monthly rental payments of $25,208 for the Initial Early Term, $88,254 for the Early Term and initial monthly payments of approximately $111,171 in the first year of the remaining term. Following the first year of the remaining term, the annual base rent will increase by approximately 2.75% annually over the remaining term. The lease also contains six months of rent abatement (months 1, 2, 3, 25, 26 and 27 of the remaining lease term). In addition to the base rent, payments of operating expenses and real estate taxes will be required. These payments are to be based on actual amounts incurred during 2021 multiplied by the Company’s share of the total building space (92.3%). The landlord will also provide an allowance of approximately $1,455,000 related to certain building improvements as outlined in the lease. In April 2021, the Company provided the landlord with a letter of credit in the amount of approximately $1,467,000 as security. The Company has determined that this lease should be treated as an operating lease in accordance with the provisions of Accounting Standards Codification (“ASC”) 842. On April 1, 2021, the Company recorded a Right-of-Use asset and related lease liability In September 2021, the Company extended its two operating leases for its office facility in Germany. These leases require combined base rent payments amounting to approximately $12,100 per month. The initial lease term of both leases ends August 31, 2026. In addition, the Company is obligated to monthly operating expenses of approximately $3,000 per month. Both leases have a five-year option to renew that would extend the lease term to August 31, 2031. 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. In January 2021, CytoSorbents Europe GmbH entered into a lease for 1,068 square meters of additional warehouse space. The lease commenced on April 1, 2021 and requires monthly payments of base rent of $7,784 and other costs of approximately $239 and has a term of five years. The lease also has an option to extend liability Right-Of-Use Asset and Lease Liability The Company’s consolidated balance sheets 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 of the facilities in Germany and do not include the renewal periods for the United States facility. The discount rate used was the Company’s incremental borrowing rate, which is 9.8%, as the Company could not determine the rate implicit in the lease. As a result, the value of the right-of- use asset and related lease liability is as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ December 31, ​ 2024 2023 Right-of-use asset ​ $ 11,651,563 ​ $ 12,058,896 ​ ​ ​ ​ ​ ​ ​ Total lease liability ​ $ 13,000,742 ​ $ 13,270,295 Less current portion ​ (431,997) ​ ​ (373,636) Lease liability, net of current portion ​ $ 12,568,745 ​ $ 12,896,659 ​ The maturities of the lease liabilities are as follows for the periods ending September 30: ​ ​ ​ ​ 2025 $ 1,685,727 2026 ​ 1,725,524 2027 ​ 1,766,416 2028 ​ 1,808,432 2029 ​ 1,851,603 Thereafter ​ 14,024,373 Total lease payments ​ ​ 22,862,075 Present value discount ​ ​ (9,861,333) Total ​ $ 13,000,742 ​ For the three months ended September 30, 2024 and 2023, operating cash flows paid in connection with operating leases amounted to approximately $547,000 and $633,000, respectively, and $1,684,000 and $1,801,000, respectively, for the nine months ended September 30, 2024 and 2023. As of September 30, 2024 and December 31, 2023, the weighted average remaining lease term was years 11.9 and 12.7 years, respectively.

NET LOSS PER SHARE

NET LOSS PER SHARE	9 Months Ended
	Sep. 30, 2024
NET LOSS PER SHARE
NET LOSS PER SHARE	8. NET LOSS PER SHARE Basic loss per share and diluted loss per share for the three and nine months ended September 30, 2024 and 2023 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, options and restricted stock awards representing approximately 20,328,000 and 14,119,000 incremental shares at September 30, 2024 and 2023, respectively, have been excluded from the computation of diluted loss per share as they are anti-dilutive.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ (2,334,091)	$ (9,193,520)	$ (12,835,098)	$ (22,672,487)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Sep. 30, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

PRINCIPAL BUSINESS ACTIVITY A_2

PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	9 Months Ended
	Sep. 30, 2024
PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Nature of Business	Nature of Business The Company is a leader in the treatment of life-threatening conditions in intensive care and cardiac surgery using blood purification. 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 CytoSorb device.
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. 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 of America dollar the foreign currency financial statements of the European subsidiary, for which the United States of America dollar is the functional currency, are included in operations. The Euro is the functional currency of the European Subsidiary. Foreign currency transaction gain (loss) included in net loss amounted to approximately $2,650,000 and $(1,810,000) for the three months ended September 30, 2024 and 2023, respectively. Foreign currency transaction gain (loss) included in net loss amounted to approximately $680,000 and $(734,000) for the nine months ended September 30, 2024 and 2023, respectively. The Company translates assets and liabilities of all of its foreign subsidiaries at the exchange rate in effect at the condensed consolidated 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, Cash Equivalents and Restricted Cash	Cash, Cash Equivalents and Restricted Cash The Company considers all highly liquid investments purchased with an original maturity of three months or less to be cash equivalents. The following table provides a reconciliation of cash and cash equivalents and restricted cash to amounts shown in the consolidated balance sheets: ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2024 December 31, 2023 Cash and cash equivalents ​ $ 5,685,328 ​ $ 14,131,137 Restricted cash ​ 6,483,958 ​ 1,483,958 Total cash, cash equivalents and restricted cash ​ $ 12,169,286 ​ $ 15,615,095 ​
Restricted Cash	Restricted Cash The Company’s total restricted cash in the amount of $6,483,958 consists of cash of $5,000,000 which is restricted in accordance with the terms of the debt agreement with Avenue Capital Group (see Note 5), cash of $1,467,458 that the Company is obligated to maintain as collateral for the outstanding letter of credit with Bridge Bank that was provided to the landlord of the College Road facility as security and cash of $16,500 that the Company is obligated to maintain as collateral for the credit limit on the Company’s credit card accounts.
Grants and Accounts Receivable	Grants and Accounts Receivable Trade accounts receivable consist of amounts due from direct customers, distributors and agencies of the U.S. government and are presented at net realizable value. At each balance sheet date, the Company estimates an expected allowance for credit losses inherent in the Company’s accounts receivable portfolio based on historical experience, specific allowances for known troubled accounts, and other available evidence. In addition, also at each reporting date, this estimate is updated to reflect any changes in credit risk since the receivable was initially recorded. This estimate is calculated on a pooled basis where similar risk characteristics exist. The Company has identified the following portfolio segments: direct customers, distributors/strategic partners and the U.S. government. A fixed reserve percentage for each pool is derived from a review of the Company’s historical losses in relation to the total pool. This estimate is adjusted quarterly for management’s assessment of current conditions, reasonable and supportable forecasts regarding future events, and any other factors deemed relevant by the Company. The Company believes historical loss information is a reasonable starting point in which to calculate the expected allowance for credit losses as the Company’s portfolio segments have remained constant over the Company’s historical evaluation period. The Company writes off receivables when there is information that indicates the debtor is facing significant financial difficulty and there is no possibility of recovery. If any recoveries are made from any accounts previously written off, they are recognized as an offset to credit loss expense in the year of recovery. The total amount of write-offs was immaterial to the consolidated financial statements as a whole for the three and nine months ended September 30, 2024 and 2023. The allowance for credit losses reflects accounts receivable balances that are written off when management determines they are uncollectible. The allowance for credit losses is measured on a collective (pool) basis when similar risk characteristics exist, and measures the allowance for credit losses using the following methods: Direct Customers—The Company measures expected credit losses on direct customer receivables using an aging methodology. The risk of loss for direct customer receivables is low based on the Company’s historical experience. The estimate of expected credit losses considers historical credit loss information that is adjusted for current conditions and supportable forecasts. Distributors/Strategic Partners—The Company measures expected credit losses on distributor receivables using an individual reserve methodology. The risk of loss in this portfolio is low based on the Company’s historical experience. The estimate of expected credit losses considers the past payment history of each distributor. U.S. Government— These receivables are related to the Company’s government grants. The Company measures expected credit losses on these receivables using an individual reserve methodology. The risk of loss in this portfolio is very low based on the Company’s historical experience, as these receivables are supported by approved grant award contracts.
Inventories	Inventories Inventories are valued at the lower of cost or net realizable value under the first in, first out (FIFO) method. At September 30, 2024 and December 31, 2023, the Company’s inventory was comprised of finished goods, which amounted to $1,430,325 and $2,155,457, respectively; work in process, which amounted to $1,049,319 and $838,871, respectively; and raw materials, which amounted to $768,112 and $685,801, 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. Donated devices are removed from inventory and charged to selling, general and administrative expenses.
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. During the three months ended September 30, 2024 and 2023, the Company recorded impairment charges of approximately $64,000 and $183,000, respectively, and during the nine months ended September 30, 2024 and 2023, the Company recorded impairment charges of approximately $313,000 and $476,000, respectively, related to the impairment of certain issued patents and pending patent applications in certain specific jurisdictions and the abandonment of certain pending patent application costs in the ordinary course of business. This charge is included in legal, financial and other consulting in the consolidated statements of operations and comprehensive loss.
Income Taxes	Income Taxes The Company has not recorded income tax expense or income tax benefit for the three and nine months ended September 30, 2024, and 2023 due to the generation of net operating losses, the benefits of which have been fully reserved. Deferred income taxes are accounted for using the balance sheet approach, which requires recognition of deferred tax assets and liabilities for the expected future consequences of temporary differences between the financial reporting basis and the tax basis of assets and liabilities. A valuation allowance is provided when it is more likely than not that a deferred tax asset will not be realized. A full valuation allowance has been established on the deferred tax asset as it is more likely than not that a future tax benefit will not be realized. In addition, future utilization of the available net operating loss carryforward may be limited under Internal Revenue Code Section 382 as a result of changes in ownership. The Company follows accounting standards associated with uncertain tax positions. The Company had no unrecognized tax benefits at September 30, 2024. The Company is accounting for an uncertain tax position of approximately $2.1 million for the year ended December 31, 2023. 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 carryforwards to an industrial company.
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 (“FDIC”). Beginning in April of 2023, the Company joined the IntraFi network, and established an Insured Cash Sweep (“ICS”) account whereby all cash that was previously held in the Company’s money market account at Bridge Bank is swept daily in increments of less than $250,000 and deposited in a number of IntraFi’s 4,000 member banks. This arrangement provides FDIC insurance coverage for all of the cash balances previously held in the money market account, which represents all of the cash and cash equivalents held at Bridge Bank. This arrangement excludes the restricted cash balances. Management monitors the soundness of these institutions in an effort to minimize its collection risk of these balances. A significant portion of the Company’s revenues are from product sales in Germany. Substantially all of the Company’s grant and other income are from government agencies in the United States. (See Note 4 for further information relating to the Company’s revenue.) As of September 30, 2024, two distributors accounted for approximately 31% of outstanding grants and accounts receivable. As of December 31, 2023, one distributor accounted for approximately 19% of outstanding grants and accounts receivable. For the three months ended September 30, 2024 and 2023, no distributor or direct customers accounted for more than 10% of the Company’s total revenue. For the nine months ended September 30, 2024 and 2023, one distributor accounted for approximately 10% for each period, of the Company’s total revenue.
Warrants	Warrants The Company accounts for warrants as either equity-classified or liability-classified instruments based on an assessment of the warrant’s specific terms and applicable authoritative guidance in ASC 480 “Distinguishing Liabilities From Equity” (“ASC 480”) and ASC 815 “Derivatives and Hedging” (“ASC 815”). The assessment considers whether the warrants are freestanding financial instruments pursuant to ASC 480, meet the definition of a liability pursuant to ASC 480, and whether the warrants meet all of the requirements for equity classification under ASC 815, including whether the warrants are indexed to the Company’s own ordinary shares and whether the warrant holders could potentially require “net cash settlement” in a circumstance outside of the Company’s control, among other conditions for equity classification. This assessment, which requires the use of professional judgment, is conducted at the time of warrant issuance and as of each subsequent quarterly period end date while the warrants are outstanding. For issued or modified warrants that meet all of the criteria for equity classification, the warrants are required to be recorded as a component of equity at the time of issuance, and will remain as a component of equity thereafter. For issued or modified warrants that do not meet all the criteria for equity classification, the warrants are required to be recorded as liabilities at their initial fair value on the date of issuance, and each balance sheet date thereafter. Changes in the estimated fair value of the warrants are recognized as a non-cash gain or loss on the statements of operations. The warrants issued upon the closing of the Company’s December 13, 2023 offering and the closing of the Company’s June 2024 debt financing both met the criteria for equity classification under ASC 815. Accordingly, these warrants have been classified as equity as of September 30, 2024 and December 31, 2023.
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 $89,000 and $140,000, respectively, for the three months ended September 30, 2024 and 2023, and $267,000 and $341,000, respectively, for the nine months ended September 30, 2024 and 2023.
Effect of Recent Accounting Pronouncements	Effect of Recent Accounting Pronouncements In August 2020, the FASB issued ASU 2020-06, “Debt – Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging – Contracts in Entity’s Own Equity (Subtopic 815-40)” (“ASU 2020-06”). ASU2020-06 simplifies the accounting for certain financial instruments with characteristics of liabilities and equity, including convertible instruments and contracts on an entity’s own equity. The ASU is part of the FASB’s simplification initiative, which aims to reduce unnecessary complexity in U.S. GAAP. The ASU’s amendments are effective for fiscal years beginning after December 15, 2024, and interim periods within those fiscal years. The Company adopted the provisions of ASU 2020-06 on January 1, 2024. This did not have a material impact on the Company’s consolidated financial statements. In December 2023, the FASB issued ASU No. 2023-09 entitled “Income Taxes (Topic 740): Improvements to Income Tax Disclosures”. This ASU provides guidance related to additional disclosures that will be required related to income taxes. The updated guidance is effective for public entities for fiscal years beginning after December 15, 2024. This ASU will result in additional disclosures in the Company’s consolidated financial statements related to income taxes in 2025. In November 2023, the FASB issued ASU No. 2023-07 (“ASU 2023-07”), “Improvements to Reportable Segment Disclosures”. The guidance primarily will require enhanced disclosures about significant segment expenses. All disclosure requirements under ASU 2023-07 and existing segment disclosures in ASC 280, “Segment Reporting” are also required for public entities with a single reportable segment. The amendments in ASU 2023-07 are effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. A retrospective approach is required to be applied to all prior periods presented in the financial statements. The Company plans to adopt the provisions of ASU 2023-07 in the first quarter of fiscal 2025 and continues to evaluate the disclosure requirements related to the new standard. On April 3, 2024, the Financial Accounting Standards Board (the "FASB") began a project related to the accounting and reporting of government grants. The FASB has decided to pursue an International Accounting Standards ("IAS") 20 accounting model. Under IAS 20, a grant relating to income may be reported separately as 'other income' or deducted from the related expense. The FASB expects to issue and exposure draft of a proposed ASU in the fourth quarter of 2024. The company is evaluating its accounting and reporting policy for government grants relative to this project and the requirements of IAS 20.

PRINCIPAL BUSINESS ACTIVITY A_3

PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Tables)	9 Months Ended
	Sep. 30, 2024
PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Schedule of reconciliation of cash and cash equivalents and restricted cash and cash equivalents	​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2024 December 31, 2023 Cash and cash equivalents ​ $ 5,685,328 ​ $ 14,131,137 Restricted cash ​ 6,483,958 ​ 1,483,958 Total cash, cash equivalents and restricted cash ​ $ 12,169,286 ​ $ 15,615,095

STOCKHOLDERS' EQUITY (Tables)

STOCKHOLDERS' EQUITY (Tables)	9 Months Ended
	Sep. 30, 2024
STOCKHOLDERS' EQUITY
Schedule of stock options activity	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted ​ ​ ​ ​ Weighted ​ Average ​ ​ ​ ​ Average ​ Remaining ​ ​ ​ ​ Exercise Price ​ Contractual ​ Shares per Share Life (Years) Outstanding, December 31, 2023 10,548,174 ​ $ 4.49 ​ 7.01 Granted 3,687,366 ​ $ 0.96 — Forfeited (1,018,794) ​ $ 2.69 — Expired (706,609) ​ $ 5.40 — Exercised — ​ $ — — Outstanding, September 30, 2024 12,510,137 ​ $ 3.54 7.06
Schedule of intrinsic value	The intrinsic value is calculated as the difference between the market value of the shares as of September 30, 2024 of $1.50 and the exercise price of the shares. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Options Outstanding ​ ​ Number ​ Weighted ​ Weighted ​ ​ ​ Range of ​ Outstanding at ​ Average ​ Average ​ Aggregate Exercise ​ September 30, ​ Exercise ​ Remaining ​ Intrinsic Price 2024 Price Life (Years) Value $0.84 - $13.20 12,510,137 ​ $ 3.54 ​ 7.06 ​ $ 1,892,822 ​ ​ ​ ​ ​ ​ ​ ​ Options Exercisable Number ​ Weighted ​ Exercisable at ​ Average ​ Aggregate September 30, ​ Exercise ​ Intrinsic 2024 Price Value 6,164,466 ​ $ 5.48 ​ $ 33,555
Schedule of company's non-vested options	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted ​ ​ ​ ​ Average ​ ​ ​ ​ Grant Date ​ Shares Fair Value ​ ​ ​ ​ ​ ​ Non-vested, December 31, 2023 5,205,736 ​ $ 1.89 Granted 3,687,366 ​ $ 0.67 Forfeited (1,018,794) ​ $ 1.81 Vested (1,528,637) ​ $ 2.30 Non-vested, September 30, 2024 6,345,671 ​ $ 1.08
Schedule of restricted stock unit	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Restricted Stock Units ​ ​ ​ Board of Executive Other ​ ​ ​ ​ ​ Directors ​ Management Employees Total ​ Intrinsic Value December 31, 2023 346,500 779,500 1,697,500 2,823,500 $ 3,134,085 Granted — 175,000 156,250 331,250 ​ ​ Forfeited — — (330,750) (330,750) ​ ​ September 30, 2024 346,500 954,500 1,523,000 2,824,000 ​ $ 4,236,000
Schedule of the restricted stock unit activity	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted ​ ​ ​ ​ Average ​ ​ ​ ​ Grant Date ​ Shares Fair Value Non-vested, December 31, 2023 430,505 ​ $ 3.31 Granted ​ 548,000 ​ $ 0.96 Vested (297,169) ​ $ 3.23 Forfeited ​ (40,000) ​ $ 3.73 Non-vested, September 30, 2024 ​ 641,336 ​ $ 1.31

REVENUE (Tables)

REVENUE (Tables)	9 Months Ended
	Sep. 30, 2024
REVENUE
Schedule of disaggregation of revenue	The following table disaggregates the Company’s revenue by customer type and geographic area for the three months ended September 30, 2024: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ ​ ​ ​ ​ ​ ​ ​ Distributors/ ​ Government ​ ​ ​ ​ Direct Strategic Partners Agencies Total Product sales: ​ ​ ​ ​ United States ​ $ 20,705 ​ $ — ​ $ — ​ $ 20,705 Germany ​ 3,180,863 ​ ​ — ​ ​ — ​ ​ 3,180,863 All other countries ​ 1,937,580 ​ ​ 3,473,647 ​ ​ — ​ ​ 5,411,227 Total product revenue ​ 5,139,148 ​ ​ 3,473,647 ​ ​ — ​ ​ 8,612,795 Grant and other income: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ — ​ ​ — ​ ​ 777,593 ​ ​ 777,593 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total revenue ​ $ 5,139,148 ​ $ 3,473,647 ​ $ 777,593 ​ $ 9,390,388 ​ The following table disaggregates the Company’s revenue by customer type and geographic area for the three months ended September 30, 2023: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ ​ ​ ​ ​ ​ ​ ​ Distributors/ ​ Government ​ ​ ​ ​ Direct Strategic Partners Agencies Total Product sales: ​ ​ ​ ​ United States ​ $ 44,933 ​ $ — ​ $ — ​ $ 44,933 Germany ​ 2,937,431 ​ ​ — ​ ​ — ​ ​ 2,937,431 All other countries ​ 1,267,051 ​ ​ 3,504,601 ​ ​ — ​ ​ 4,771,652 Total product revenue ​ 4,249,415 ​ ​ 3,504,601 ​ ​ — ​ ​ 7,754,016 Grant and other income: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ — ​ ​ — ​ ​ 1,056,831 ​ ​ 1,056,831 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total revenue ​ $ 4,249,415 ​ $ 3,504,601 ​ $ 1,056,831 ​ $ 8,810,847 ​ The following table disaggregates the Company’s revenue by customer type and geographic area for the nine months ended September 30, 2024: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ ​ ​ ​ ​ ​ ​ ​ Distributors/ ​ Government ​ ​ ​ ​ Direct Strategic Partners Agencies Total Product sales: ​ ​ ​ ​ United States ​ $ 62,719 ​ $ 36,000 ​ $ — ​ $ 98,719 Germany ​ 9,497,184 ​ ​ — ​ ​ — ​ ​ 9,497,184 All other countries ​ 5,361,933 ​ ​ 11,486,268 ​ ​ — ​ ​ 16,848,201 Total product revenue ​ 14,921,836 ​ ​ 11,522,268 ​ ​ — ​ ​ 26,444,104 Grant and other income: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ — ​ ​ — ​ ​ 2,627,212 ​ ​ 2,627,212 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total revenue ​ $ 14,921,836 ​ $ 11,522,268 ​ $ 2,627,212 ​ $ 29,071,316 ​ The following table disaggregates the Company’s revenue by customer type and geographic area for the nine months ended September 30, 2023: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ ​ ​ ​ ​ ​ ​ ​ Distributors/ ​ Government ​ ​ ​ ​ Direct Strategic Partners Agencies Total Product sales: ​ ​ ​ ​ United States ​ $ 55,284 ​ $ — ​ $ — ​ $ 55,284 Germany ​ 9,443,787 ​ ​ — ​ ​ — ​ ​ 9,443,787 All other countries ​ 4,263,375 ​ ​ 9,974,022 ​ ​ — ​ ​ 14,237,397 Total product revenue ​ 13,762,446 ​ ​ 9,974,022 ​ ​ — ​ ​ 23,736,468 Grant and other income: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ — ​ ​ — ​ ​ 3,944,696 ​ ​ 3,944,696 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total revenue ​ $ 13,762,446 ​ $ 9,974,022 ​ $ 3,944,696 ​ $ 27,681,164
Schedule of receivables and contract liabilities from contracts with customers	​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, 2024 December 31, 2023 Receivables, which are included in grants and accounts receivable ​ $ 4,845,233 ​ $ 3,846,271 Contract liabilities, which are included in accrued expenses and other current liabilities ​ $ 837,592 ​ $ 1,573,141

LONG-TERM DEBT, NET (Tables)

LONG-TERM DEBT, NET (Tables)	9 Months Ended
	Sep. 30, 2024
LONG-TERM DEBT, NET
Schedule of Long-term debt	Long-term debt consists of the following as of September 30, 2024: ​ ​ ​ ​ Principal amount $ 15,000,000 Accrued final fee ​ 900,000 Less unamortized debt discount ​ ​ (1,455,858) Less unamortized debt acquisition costs ​ ​ (638,157) Subtotal ​ 13,805,985 Less Current maturities ​ — Long-term debt net of current maturities ​ $ 13,805,985
Schedule of Principal payments of long-term debt	Principal payments of long-term debt are due as follows during the periods ending September 30: ​ ​ ​ ​ 2025 $ — 2026 ​ 2,500,000 2027 ​ 12,500,000 2028 ​ ​ — Total ​ $ 15,000,000

LEASES (Tables)

LEASES (Tables)	9 Months Ended
	Sep. 30, 2024
LEASES
Schedule of right-of- use asset and related lease liability	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ December 31, ​ 2024 2023 Right-of-use asset ​ $ 11,651,563 ​ $ 12,058,896 ​ ​ ​ ​ ​ ​ ​ Total lease liability ​ $ 13,000,742 ​ $ 13,270,295 Less current portion ​ (431,997) ​ ​ (373,636) Lease liability, net of current portion ​ $ 12,568,745 ​ $ 12,896,659
Schedule of maturities of the lease liabilities	The maturities of the lease liabilities are as follows for the periods ending September 30: ​ ​ ​ ​ 2025 $ 1,685,727 2026 ​ 1,725,524 2027 ​ 1,766,416 2028 ​ 1,808,432 2029 ​ 1,851,603 Thereafter ​ 14,024,373 Total lease payments ​ ​ 22,862,075 Present value discount ​ ​ (9,861,333) Total ​ $ 13,000,742

BASIS OF PRESENTATION (Details)

BASIS OF PRESENTATION (Details) - USD ($)	9 Months Ended
	Sep. 30, 2024	Dec. 31, 2023
BASIS OF PRESENTATION
Cash and cash equivalents gross value	$ 12,200,000
Cash and cash equivalents	5,685,328	$ 14,131,137
Restricted cash	6,500,000
Maximum
BASIS OF PRESENTATION
Increase in unrestricted cash related to debt facility	$ 10,000,000

PRINCIPAL BUSINESS ACTIVITY A_4

PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details)	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2024 USD ($) Distributor	Sep. 30, 2023 USD ($) Distributor	Sep. 30, 2024 USD ($) Distributor item	Sep. 30, 2023 USD ($) Distributor	Dec. 31, 2023 USD ($) Distributor
PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Foreign currency transaction gain (loss)	$ 2,650,000	$ (1,810,000)	$ 680,000	$ (734,000)
Restricted cash	6,483,958		6,483,958		$ 1,483,958
Inventory - finished goods	1,430,325		1,430,325		2,155,457
Inventory - work in process	1,049,319		1,049,319		838,871
Inventory - raw materials	768,112		768,112		685,801
Impairment charges	64,000	183,000	313,000	476,000
Income tax expense	0	0	0	0
Unrecognized tax benefits	0		$ 0		$ 2,100,000
Number of member bank | item			4,000
Cost of revenue	4,108,773	3,203,981	$ 10,716,394	10,600,421
Debt agreement
PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Restricted cash	5,000,000		5,000,000
Letter of credit
PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Cash collateral	1,467,458		1,467,458
Credit Card
PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Cash collateral	16,500		16,500
Cargo and Freight
PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Cost of revenue	$ 89,000	$ 140,000	$ 267,000	$ 341,000
Accounts receivable | Customer concentration risk | Distributors/Strategic Partners
PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Number of distributors | Distributor			2		1
Concentration risk percentage			31%		19%
Revenue | Customer concentration risk | Distributors/Strategic Partners
PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Number of distributors | Distributor	0	0	1	1
Concentration risk percentage	10%	10%	10%	10%

PRINCIPAL BUSINESS ACTIVITY A_5

PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Cash and cash equivalents (Details) - USD ($)	Sep. 30, 2024	Dec. 31, 2023	Sep. 30, 2023	Dec. 31, 2022
PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Cash and cash equivalents	$ 5,685,328	$ 14,131,137
Restricted cash	6,483,958	1,483,958
Total cash, cash equivalents and restricted cash	$ 12,169,286	$ 15,615,095	$ 10,046,506	$ 23,832,026

STOCKHOLDERS' EQUITY - Stock op

STOCKHOLDERS' EQUITY - Stock option activity (Details) - $ / shares	9 Months Ended	12 Months Ended
	Sep. 30, 2024	Dec. 31, 2023
Shares
Outstanding, beginning of the year	10,548,174
Granted	3,687,366
Forfeited	(1,018,794)
Expired	(706,609)
Outstanding, end of the year	12,510,137	10,548,174
Weighted Average Exercise Price per Share
Outstanding, beginning of the year	$ 4.49
Granted	0.96
Forfeited	2.69
Expired	5.40
Outstanding, end of the year	$ 3.54	$ 4.49
Weighted Average Remaining Contractual Life (Years)
Outstanding, beginning of the year		7 years 3 days
Granted	0 years
Forfeited	0 years
Expired	0 years
Exercised	0 years
Outstanding, end of the year	7 years 21 days

STOCKHOLDERS' EQUITY - Intrinsi

STOCKHOLDERS' EQUITY - Intrinsic value (Details)	9 Months Ended
	Sep. 30, 2024 USD ($) $ / shares shares
Options Exercisable
Number Exercisable at September 30, 2024 | shares	6,164,466
Weighted Average Exercise Price	$ 5.48
Aggregate Intrinsic Value | $	$ 33,555
Exercise Price Range One
Options Outstanding
Range of Exercise Price, Lower Range Limit	$ 0.84
Range of Exercise Price, Upper Range Limit	$ 13.20
Number Outstanding at September 30, 2024 | shares	12,510,137
Weighted Average Exercise Price	$ 3.54
Weighted Average Remaining Life (Years)	7 years 21 days
Aggregate intrinsic value | $	$ 1,892,822

STOCKHOLDERS' EQUITY - Non-vest

STOCKHOLDERS' EQUITY - Non-vested options (Details)	9 Months Ended
	Sep. 30, 2024 $ / shares shares
Shares
Non-vested, December 31, 2023 | shares	5,205,736
Granted | shares	3,687,366
Forfeited | shares	(1,018,794)
Vested | shares	(1,528,637)
Non-vested, September 30, 2024 | shares	6,345,671
Weighted Average Grant Date Fair Value
Non-vested, December 31, 2023 | $ / shares	$ 1.89
Granted | $ / shares	0.67
Forfeited | $ / shares	1.81
Vested | $ / shares	2.30
Non-vested, September 30, 2024 | $ / shares	$ 1.08

STOCKHOLDERS' EQUITY - Restrict

STOCKHOLDERS' EQUITY - Restricted stock unit (Details) - Restricted stock - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
STOCKHOLDERS' EQUITY
Restricted Stock Units, Beginning Balance			2,823,500
Restricted Stock Units, Intrinsic Value Beginning Balance			$ 3,134,085
Granted			331,250
Forfeited			(330,750)
Restricted Stock Units, Ending Balance	2,824,000		2,824,000
Restricted Stock Units, Intrinsic Value Ending Balance	$ 4,236,000		$ 4,236,000
Restricted Stock Units, Expense	$ 0	$ 0	$ 0	$ 0
Board of Directors
STOCKHOLDERS' EQUITY
Restricted Stock Units, Beginning Balance			346,500
Granted			0
Forfeited			0
Restricted Stock Units, Ending Balance	346,500		346,500
Executive Management
STOCKHOLDERS' EQUITY
Restricted Stock Units, Beginning Balance			779,500
Granted			175,000
Forfeited			0
Restricted Stock Units, Ending Balance	954,500		954,500
Other Employees
STOCKHOLDERS' EQUITY
Restricted Stock Units, Beginning Balance			1,697,500
Granted			156,250
Forfeited			(330,750)
Restricted Stock Units, Ending Balance	1,523,000		1,523,000

STOCKHOLDERS' EQUITY - Restri_2

STOCKHOLDERS' EQUITY - Restricted stock unit activity (Details) - Restricted stock	9 Months Ended
	Sep. 30, 2024 $ / shares shares
Shares
Non-vested, December 31, 2023 | shares	430,505
Granted | shares	548,000
Vested | shares	(297,169)
Forfeited | shares	(40,000)
Non-vested, September 30, 2024 | shares	641,336
Weighted Average Grant Date Fair Value
Non-vested, December 31, 2023 | $ / shares	$ 3.31
Granted | $ / shares	0.96
Vested | $ / shares	3.23
Forfeited | $ / shares	3.73
Non-vested, September 30, 2024 | $ / shares	$ 1.31

STOCKHOLDERS' EQUITY - Warrants

STOCKHOLDERS' EQUITY - Warrants (Details) - $ / shares		9 Months Ended
	Jun. 28, 2024	Sep. 30, 2024	Dec. 31, 2023
STOCKHOLDERS' EQUITY
Number of shares to be purchased		4,352,130	2,706,561
Warrant exercise price per share			$ 2
Stock price trigger for revision of exercise price of warrants	$ 0.79
Loan and security agreement
STOCKHOLDERS' EQUITY
Warrant exercise price per share	$ 0.79	$ 0.79
Class of warrant issued	1,645,569
Stock price trigger for revision of exercise price of warrants		$ 0.79

STOCKHOLDERS' EQUITY - Addition

STOCKHOLDERS' EQUITY - Additional information (Details)									3 Months Ended		9 Months Ended			12 Months Ended
	Aug. 14, 2024 USD ($) shares	Apr. 08, 2024 USD ($) shares	Apr. 02, 2024 USD ($) shares	Mar. 29, 2024 USD ($) shares	Sep. 18, 2023 USD ($) shares	Jul. 07, 2023 USD ($) shares	Aug. 10, 2022 USD ($) shares	Dec. 30, 2021 USD ($)	Sep. 30, 2024 USD ($) $ / shares shares	Sep. 30, 2023 USD ($) shares	Sep. 30, 2024 USD ($) $ / shares shares	Sep. 30, 2024 USN ($) shares	Sep. 30, 2023 USD ($) shares	Dec. 31, 2023 USD ($) $ / shares shares	Dec. 31, 2022 shares	Jul. 26, 2024 USD ($)	Jul. 14, 2021 USD ($)	Jun. 30, 2019 shares
STOCKHOLDERS' EQUITY
Number of preferred stock authorized									5,000,000		5,000,000			5,000,000				5,000,000
Common Stock, shares authorized									100,000,000		100,000,000			100,000,000
Issuance of common stock															0
Aggregate registered amount for offerings | $																$ 150,000,000	$ 150,000,000
Restricted stock unit | $									$ 782,000	$ 1,086,000	$ 2,345,000		$ 2,487,000
Grant date exercise price range | $ / shares									$ 1.50		$ 1.50
Total unrecognized compensation cost related to stock options | $									$ 3,540,000		$ 3,540,000
Amortized period											35 months	35 months
Vested											1,528,637	1,528,637
Outstanding									12,510,137		12,510,137			10,548,174
Issuance of restricted stock units | $									$ 186,884	$ 220,286	$ 198,097		$ 403,941
Maximum
STOCKHOLDERS' EQUITY
Common Stock, shares authorized																		100,000,000
Minimum
STOCKHOLDERS' EQUITY
Common Stock, shares authorized																		50,000,000
Common Stock
STOCKHOLDERS' EQUITY
Issuance of common stock										162,078	53,290	53,290	590,348
Issuance of restricted stock units | $									192	$ 75	$ 205		$ 130
Restricted stock
STOCKHOLDERS' EQUITY
Restricted stock unit | $									$ 4,000	4,000	$ 0		0
Options to grant (in shares)											548,000	548,000
RSU Forfeited (in shares)											40,000	40,000
Vested (in shares)											297,169	297,169
Non-Vested shares									641,336		641,336			430,505
Director | Common Stock
STOCKHOLDERS' EQUITY
Unvested options in fair value | $			$ 71,000
Number of options granted			110,000
Employee one | Common Stock
STOCKHOLDERS' EQUITY
Unvested options in fair value | $		$ 85,000	$ 830,000
Number of options granted		131,339	1,214,400
Employee one | Common Stock | Vesting, tranche one
STOCKHOLDERS' EQUITY
Vesting percentage			0.50%
Employee one | Common Stock | Vesting, tranche two
STOCKHOLDERS' EQUITY
Vesting percentage			0.25%
Employee one | Common Stock | Vesting, tranche three
STOCKHOLDERS' EQUITY
Vesting percentage			0.25%
Employee Stock
STOCKHOLDERS' EQUITY
Outstanding									78,000		78,000
Employee two | Common Stock
STOCKHOLDERS' EQUITY
Unvested options in fair value | $			$ 594,000
Number of options granted			922,147
Chief Executive Officer | Vesting, tranche one
STOCKHOLDERS' EQUITY
Unvested options in fair value | $				$ 249,000
Chief Executive Officer | Common Stock
STOCKHOLDERS' EQUITY
Number of options granted				380,480
Senior managers | Common Stock
STOCKHOLDERS' EQUITY
Unvested options in fair value | $			$ 380,000
Number of options granted			556,000
Senior managers | Common Stock | Vesting, tranche one
STOCKHOLDERS' EQUITY
Vesting percentage			0.50%
Senior managers | Common Stock | Vesting, tranche two
STOCKHOLDERS' EQUITY
Vesting percentage			0.25%
Senior managers | Common Stock | Vesting, tranche three
STOCKHOLDERS' EQUITY
Vesting percentage			0.25%
Senior managers | Restricted stock
STOCKHOLDERS' EQUITY
Restricted stock unit | $									$ 41,000	0	$ 81,000		0
Stock issued during period, value, restricted stock sward, gross | $			$ 328,000
Options to grant (in shares)			343,000
Executive officers and senior managers | Restricted stock
STOCKHOLDERS' EQUITY
Restricted stock unit									(67,000)	106,000		$ 27,000	214,000
Stock issued during period, shares, restricted stock award, gross							288,500
Stock issued during period, value, restricted stock sward, gross | $							$ 563,000
Executive officers and senior managers | Restricted stock
STOCKHOLDERS' EQUITY
Restricted stock unit | $									(234,000)	102,000	(13,000)		0
Stock issued during period, shares, restricted stock award, gross						250,000
Stock issued during period, value, restricted stock sward, gross | $						$ 883,000
Executive officer | Restricted stock
STOCKHOLDERS' EQUITY
Restricted stock unit | $									(1,000)	50,000	9,000		0
Vested					25,000
Stock issued during period, shares, restricted stock award, gross					45,000
Stock issued during period, value, restricted stock sward, gross | $					$ 89,000
Executive officer | Restricted stock | Vesting, tranche one
STOCKHOLDERS' EQUITY
Vested					10,000
Executive officer | Restricted stock | Vesting, tranche two
STOCKHOLDERS' EQUITY
Vested					10,000
Certain employees | Restricted stock
STOCKHOLDERS' EQUITY
Restricted stock unit | $									(23,000)	$ 8,000	$ (186,000)		$ 0
Options to grant (in shares)			213,000
Issuance of restricted stock units | $			$ 517,000
RSU Forfeited (in shares)											40,000	40,000
RSU Forfeited | $											$ 149,000
Vested (in shares)											33,000	33,000
Vested | $											$ 231,000
Certain employees | Restricted stock | Anniversary of the award
STOCKHOLDERS' EQUITY
Non-Vested shares			140,000
Certain employees | Restricted stock | Maximum | Vesting upon earlier of change in control or three years from date of award
STOCKHOLDERS' EQUITY
Vesting period			4 years
Certain employees | Restricted stock | Minimum | Vesting upon earlier of change in control or three years from date of award
STOCKHOLDERS' EQUITY
Vesting period			3 years
Chief Financial Officer
STOCKHOLDERS' EQUITY
Number of options granted	41,000
Options to purchase common stock vested	80,000
Chief Financial Officer | Vesting, tranche one
STOCKHOLDERS' EQUITY
Options to grant (in shares)	13,000
Chief Financial Officer | Common Stock
STOCKHOLDERS' EQUITY
Shares issued other (in shares)	215,000
Chief Financial Officer | Restricted stock
STOCKHOLDERS' EQUITY
Stock issued during period, shares, restricted stock award, gross	65,000
Stock issued during period, value, restricted stock sward, gross | $	$ 63,000
Jefferies LLC and B. Riley FBR, Inc
STOCKHOLDERS' EQUITY
Issuance of common stock											53,290	53,290		2,656,464
Net proceeds from issuance of stock | $											$ 53,000			$ 4,532,000
ATM activation fees | $									$ 41,000		$ 41,000
Commission rate (as a percent)									3%		3%
Net proceeds from issuance of stock | $														$ 61,000
Average selling price | $ / shares									$ 1.03		$ 1.03			$ 1.76
Jefferies LLC and B. Riley FBR, Inc | Scenario one limitations related to our market capitalization
STOCKHOLDERS' EQUITY
Aggregate offering price | $								$ 25,000,000
Jefferies LLC and B. Riley FBR, Inc | Scenario two limitations related to our market capitalization
STOCKHOLDERS' EQUITY
Aggregate offering price | $								$ 19,700,000
Exercise Price Ranging From 0.84 to 1.08
STOCKHOLDERS' EQUITY
Expected life of the stock option											6 years	6 years
Current price of the underlying stock and its expected volatility range											77.80%	77.80%
Expected dividends											0%	0%
Risk free interest rate, minimum											3.60%	3.60%
Risk free interest rate range											4.65%	4.65%
Exercise Price Ranging From 0.84 to 1.08 | Maximum
STOCKHOLDERS' EQUITY
Grant date exercise price range | $ / shares									1.08		$ 1.08
Exercise Price Ranging From 0.84 to 1.08 | Minimum
STOCKHOLDERS' EQUITY
Grant date exercise price range | $ / shares									$ 0.84		$ 0.84

REVENUE - Revenue by customer t

REVENUE - Revenue by customer type and geographic area (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Product sales:
Total revenue	$ 9,390,388	$ 8,810,847	$ 29,071,316	$ 27,681,164
Total product sales
Product sales:
Total revenue	8,612,795	7,754,016	26,444,104	23,736,468
Grant income
Product sales:
Total revenue	777,593	1,056,831	2,627,212	3,944,696
United States | Total product sales
Product sales:
Total revenue	20,705	44,933	98,719	55,284
United States | Grant income
Product sales:
Total revenue	777,593	1,056,831	2,627,212	3,944,696
Germany | Total product sales
Product sales:
Total revenue	3,180,863	2,937,431	9,497,184	9,443,787
All other countries | Total product sales
Product sales:
Total revenue	5,411,227	4,771,652	16,848,201	14,237,397
Direct
Product sales:
Total revenue	5,139,148	4,249,415	14,921,836	13,762,446
Direct | Total product sales
Product sales:
Total revenue	5,139,148	4,249,415	14,921,836	13,762,446
Direct | United States | Total product sales
Product sales:
Total revenue	20,705	44,933	62,719	55,284
Direct | Germany | Total product sales
Product sales:
Total revenue	3,180,863	2,937,431	9,497,184	9,443,787
Direct | All other countries | Total product sales
Product sales:
Total revenue	1,937,580	1,267,051	5,361,933	4,263,375
Distributors/Strategic Partners
Product sales:
Total revenue	3,473,647	3,504,601	11,522,268	9,974,022
Distributors/Strategic Partners | Total product sales
Product sales:
Total revenue	3,473,647	3,504,601	11,522,268	9,974,022
Distributors/Strategic Partners | United States | Total product sales
Product sales:
Total revenue			36,000
Distributors/Strategic Partners | All other countries | Total product sales
Product sales:
Total revenue	3,473,647	3,504,601	11,486,268	9,974,022
United States Government Agencies
Product sales:
Total revenue	777,593	1,056,831	2,627,212	3,944,696
United States Government Agencies | United States | Grant income
Product sales:
Total revenue	$ 777,593	$ 1,056,831	$ 2,627,212	$ 3,944,696

REVENUE - Receivables and contr

REVENUE - Receivables and contract liabilities (Details) - USD ($)	Sep. 30, 2024	Dec. 31, 2023
REVENUE
Receivables, which are included in grants and accounts receivable	$ 4,845,233	$ 3,846,271
Contract liabilities, which are included in accrued expenses and other current liabilities	$ 837,592	$ 1,573,141

REVENUE - Additional informatio

REVENUE - Additional information (Details)	9 Months Ended
	Sep. 30, 2024 USD ($) segment	Dec. 31, 2023 USD ($)
REVENUE
Number of primary revenue streams | segment	2
Term of customer contracts	3 years
Value of free of charge goods and credit rebates	$ 51,192	$ 196,322
Contract liabilities net of value of free of charge goods and credit rebates	786,400	1,376,819
Receivables, which are included in grants and accounts receivable	4,845,233	3,846,271
Product sales
REVENUE
Receivables, which are included in grants and accounts receivable	4,528,972	3,270,724
Government grants
REVENUE
Receivables, which are included in grants and accounts receivable	$ 316,261	$ 575,547
Maximum
REVENUE
Term of customer contracts	5 years
Minimum
REVENUE
Term of customer contracts	1 year

LONG-TERM DEBT, NET - Avenue Ca

LONG-TERM DEBT, NET - Avenue Capital Group (Details) - USD ($)		3 Months Ended	9 Months Ended
	Jun. 28, 2024	Sep. 30, 2024	Sep. 30, 2024	Dec. 31, 2023
LONG-TERM DEBT
Restricted cash		$ 6,483,958	$ 6,483,958	$ 1,483,958
Warrant Exercise Price per Share				$ 2
Stock price trigger for revision of exercise price of warrants	$ 0.79
Warrants issued in connection with long-term debt			690,709
Debt agreement
LONG-TERM DEBT
Maximum borrowing capacity		20,000,000	20,000,000
Debt instrument unused capacity		10,000,000	10,000,000
Restricted cash		5,000,000	5,000,000
Minimum net proceeds from sale of equity securities, considered for release of restricted cash		3,000,000	$ 3,000,000
Interest rate			5%
Debt Instrument, Variable Interest Rate, Type [Extensible Enumeration]			us-gaap:PrimeRateMember
Period for monthly interest only payments			25 months
Extension term of loan			30 months
Percentage of commitment fee			1%
Payment of financial advisor and legal fees			$ 640,000
Interest expense		58,000	$ 58,000
Percentage of final payment			4.50%
Interest expense		$ 132,000	$ 132,000
Minimum period after entry, over which any judgment(s) singly or in the aggregate in excess of the Threshold Amount remain unsatisfied, unvacated or unstayed, considered for events of default to trigger accelerated repayment			15 days
Period within which any insolvency proceeding brought by a third party is not dismissed or stayed, considered for events of default to trigger accelerated repayment			45 days
Warrants to purchase shares		1,645,569	1,645,569
Warrant Exercise Price per Share	$ 0.79	$ 0.79	$ 0.79
Stock price trigger for revision of exercise price of warrants			$ 0.79
Conversion of debt into common stock		$ 2,000,000	$ 2,000,000
Fixed conversion price of closing stock			120%
Fixed conversion price of closing stock, Per share			0.95%
Debt agreement | Prepayment made on or after funding date
LONG-TERM DEBT
Prepayment percentage			3%
Debt agreement | Prepayment made after first anniversary
LONG-TERM DEBT
Prepayment percentage			2%
Debt agreement | Prepayment made after second anniversary
LONG-TERM DEBT
Prepayment percentage			1%
Debt agreement | Maximum
LONG-TERM DEBT
Release of restricted cash upon equity raise		5,000,000	$ 5,000,000
Debt agreement | Minimum
LONG-TERM DEBT
Release of restricted cash upon equity raise		$ 3,000,000	$ 3,000,000
Effective rate		13.50%	13.50%
Growth Capital Loan Tranche 1
LONG-TERM DEBT
Debt instrument face amount		$ 15,000,000	$ 15,000,000
Growth Capital Loan Tranche 1 | Avenue Venture Opportunities Fund, L.P
LONG-TERM DEBT
Debt instrument face amount		4,500,000	4,500,000
Growth Capital Loan Tranche 1 | Avenue Venture Opportunities Fund II, L.P
LONG-TERM DEBT
Debt instrument face amount		10,500,000	10,500,000
Growth Capital Loan Tranche 2
LONG-TERM DEBT
Maximum borrowing capacity		$ 5,000,000	$ 5,000,000

LONG-TERM DEBT, NET (Details)

LONG-TERM DEBT, NET (Details) - USD ($)	Sep. 30, 2024	Dec. 31, 2023
LONG-TERM DEBT, NET
Principal amount	$ 15,000,000
Accrued final fee	900,000
Less unamortized debt discount	(1,455,858)
Less unamortized debt acquisition costs	(638,157)
Subtotal	13,805,985
Less Current maturities		$ (2,500,000)
Long-term debt net of current maturities	$ 13,805,985	$ 2,542,857

LONG-TERM DEBT, NET - Principal

LONG-TERM DEBT, NET - Principal payments (Details)	Sep. 30, 2024 USD ($)
LONG-TERM DEBT, NET
2026	$ 2,500,000
2027	12,500,000
Total	$ 15,000,000

LONG-TERM DEBT, NET - Additiona

LONG-TERM DEBT, NET - Additional information (Details)	9 Months Ended
	Sep. 30, 2024 USD ($) $ / shares
2022 Success Fee Letter | First Tranche
LONG-TERM DEBT
Maximum borrowing capacity | $	$ 5,000,000
Percentage of success fee	1%
Average selling price	$ 8
Number of days for stock price threshold set in success fee letter	5 days
2022 Success Fee Letter | Second Tranche
LONG-TERM DEBT
Maximum borrowing capacity | $	$ 5,000,000
Percentage of success fee	1.50%
Average selling price	$ 10
Number of days for stock price threshold set in success fee letter	5 days
2022 Success Fee Letter | Third Tranche
LONG-TERM DEBT
Maximum borrowing capacity | $	$ 5,000,000
Percentage of success fee	2%
Average selling price	$ 12
Number of days for stock price threshold set in success fee letter	5 days
Western Alliance Bank | 2018 Success Fee Letter
LONG-TERM DEBT
Percentage of success fee	6.37%
Average selling price	$ 7.05
Number of days for stock price threshold set in success fee letter	5 days
Western Alliance Bank | 2018 Success Fee Letter | Minimum
LONG-TERM DEBT
Percentage of closing price on common stock	26.13%
Western Alliance Bank | 2018 Success Fee Letter | Maximum
LONG-TERM DEBT
Percentage of closing price on common stock	70%

COMMITMENTS AND CONTINGENCIES (

COMMITMENTS AND CONTINGENCIES (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Royalty Agreement
COMMITMENTS AND CONTINGENCIES
Royalty cost	$ 354,000	$ 537,000	$ 1,594,000	$ 1,643,000

LEASES (Details)

LEASES (Details)		1 Months Ended			3 Months Ended		9 Months Ended
	Apr. 01, 2021 USD ($)	Sep. 30, 2021 USD ($)	Mar. 31, 2021 USD ($) item	Jan. 31, 2021 USD ($) m²	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	Dec. 31, 2023 USD ($)	Apr. 30, 2021 USD ($)	Apr. 01, 2020 USD ($)
LEASES:
Operating lease lability					$ 13,000,742		$ 13,000,742		$ 13,270,295
Right of use asset					$ 11,651,563		$ 11,651,563		$ 12,058,896
Incremental borrowing rate					9.80%		9.80%
Operating lease paid					$ 547,000	$ 633,000	$ 1,684,000	$ 1,801,000
Weighted average remaining lease term					11 years 10 months 24 days		11 years 10 months 24 days		12 years 8 months 12 days
CytoSorbents Medical, Inc
LEASES:
Number of times lease renewal options available | item			2
Renewal term			5 years
Rent abatement term			6 months
CytoSorbents Europe GmbH
LEASES:
Monthly payments of base rent and other costs				$ 7,784
Operating lease lability											$ 594,000
Right of use asset											$ 594,000
Area of Land | m²				1,068
Other costs	$ 239
Lease term	5 years
Existence of option to extend	true
Additional lessee operating lease term of contract option to extend	5 years
United States | CytoSorbents Medical, Inc
LEASES:
Remaining lease term			15 years 6 months
Annual rent expense increment rate			2.75%
Percentage of total building space occupied			92.30%
Allowance for building improvement			$ 1,455,000
Operating lease lability	$ 11,600,000
Right of use asset	$ 11,600,000
Incremental borrowing rate	9.80%
United States | Letter of credit | CytoSorbents Medical, Inc
LEASES:
Security amount										$ 1,467,000
United States | Initial early term | CytoSorbents Medical, Inc
LEASES:
Monthly payments of base rent and other costs			25,208
United States | Early term | CytoSorbents Medical, Inc
LEASES:
Monthly payments of base rent and other costs			88,254
United States | Early term | CytoSorbents Medical, Inc
LEASES:
Monthly payments of base rent and other costs			$ 111,171
Germany
LEASES:
Monthly payments of base rent and other costs		$ 12,100
Additional operating leases rent expense		$ 3,000

LEASES - Right-of- use asset an

LEASES - Right-of- use asset and related lease liability (Details) - USD ($)	Sep. 30, 2024	Dec. 31, 2023
LEASES
Right-of-use asset	$ 11,651,563	$ 12,058,896
Total lease liability	13,000,742	13,270,295
Less current portion	(431,997)	(373,636)
Lease liability, net of current portion	$ 12,568,745	$ 12,896,659

LEASES - Maturities of the leas

LEASES - Maturities of the lease liabilities (Details) - USD ($)	Sep. 30, 2024	Dec. 31, 2023
LEASES
2025	$ 1,685,727
2026	1,725,524
2027	1,766,416
2028	1,808,432
2029	1,851,603
Thereafter	14,024,373
Total lease payments	22,862,075
Present value discount	(9,861,333)
Total lease liability	$ 13,000,742	$ 13,270,295

NET LOSS PER SHARE (Details)

NET LOSS PER SHARE (Details) - shares	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Stock options and warrants
NET LOSS PER SHARE
Antidilutive securities excluded from computation of earnings per share	20,328,000	14,119,000