Apollo Endosurgery (APEN) 10-Q 4 May 21 2021 Q1 Quarterly report Financial data

Cover Page

Cover Page - shares	3 Months Ended
	Mar. 31, 2021	Apr. 30, 2021
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2021
Document Transition Report	false
Entity File Number	001-35706
Entity Registrant Name	APOLLO ENDOSURGERY, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	16-1630142
Entity Address, Address Line One	1120 S. Capital of Texas Highway
Entity Address, Address Line Two	Building 1, Suite #300
Entity Address, City or Town	Austin
Entity Address, State or Province	TX
Entity Address, Postal Zip Code	78746
City Area Code	512
Local Phone Number	279-5100
Title of 12(b) Security	Common stock, par value $0.001 per share
Trading Symbol	APEN
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		27,035,842
Entity Central Index Key	0001251769
Current Fiscal Year End Date	--12-31
Amendment Flag	false
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q1

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 31,710	$ 36,235
Accounts receivable, net of allowance for doubtful accounts of $606 and $634, respectively	9,463	8,218
Inventory	10,546	10,306
Prepaid expenses and other current assets	4,173	3,771
Total current assets	55,892	58,530
Restricted cash	938	965
Property, equipment and right-of-use assets, net	5,854	6,221
Goodwill	5,290	5,290
Intangible assets, net of accumulated amortization of $13,686 and $13,231, respectively	5,618	6,017
Other assets	392	414
Total assets	73,984	77,437
Current liabilities:
Accounts payable	4,576	3,675
Accrued expenses	6,907	7,357
Current portion of long-term debt	1,112	636
Total current liabilities	12,595	11,668
Long-term debt	36,998	37,192
Convertible debt	19,363	19,387
Long-term liabilities	2,337	2,439
Total liabilities	71,293	70,686
Commitments and contingencies
Stockholders' equity:
Common stock; $0.001 par value; 100,000,000 shares authorized; 27,035,842 and 25,819,329 shares issued and outstanding at March 31, 2021 and December 31, 2020, respectively	27	26
Additional paid-in capital	277,994	276,569
Accumulated other comprehensive income	2,044	2,929
Accumulated deficit	(277,374)	(272,773)
Total stockholders' equity	2,691	6,751
Total liabilities and stockholders' equity	$ 73,984	$ 77,437

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Statement of Financial Position [Abstract]
Allowance for doubtful accounts	$ 606	$ 634
Accumulated amortization	$ 13,686	$ 13,231
Common stock, par value (USD per share)	$ 0.001	$ 0.001
Common stock, shares authorized (shares)	100,000,000	100,000,000
Common stock, shares issued (shares)	27,035,842	25,819,329
Common stock, shares outstanding (shares)	27,035,842	25,819,329

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Income Statement [Abstract]
Revenues	$ 13,857	$ 10,718
Cost of sales	6,350	5,081
Gross margin	7,507	5,637
Operating expenses:
Sales and marketing	4,790	6,330
General and administrative	4,069	3,339
Research and development	1,928	2,147
Amortization of intangible assets	474	496
Total operating expenses	11,261	12,312
Loss from operations	(3,754)	(6,675)
Other expenses:
Interest expense, net	1,352	1,244
Other (income) expense, net	(564)	2,294
Net loss before income taxes	(4,542)	(10,213)
Income tax expense	59	43
Net loss	(4,601)	(10,256)
Other comprehensive (loss)/income:
Foreign currency translation	(885)	1,812
Comprehensive loss	$ (5,486)	$ (8,444)
Net loss per share, basic and diluted (USD per share)	$ (0.17)	$ (0.49)
Shares used in computing net loss per share, basic and diluted (shares)	26,306,442	21,117,126

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Changes in Stockholders’ Equity - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income	Accumulated Deficit
Beginning balance (in shares) at Dec. 31, 2019		20,951,963
Beginning balance at Dec. 31, 2019	$ 2,123	$ 21	$ 250,634	$ 1,630	$ (250,162)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of restricted stock units (in shares)		11,341
Issuance of common stock for convertible debt interest (in shares)		164,797
Issuance of common stock for convertible debt interest	467		467
Stock-based compensation	401		401
Foreign currency translation	1,812			1,812
Net loss	(10,256)				(10,256)
Ending balance (in shares) at Mar. 31, 2020		21,128,101
Ending balance at Mar. 31, 2020	$ (5,453)	$ 21	251,502	3,442	(260,418)
Beginning balance (in shares) at Dec. 31, 2020	25,819,329	25,819,329
Beginning balance at Dec. 31, 2020	$ 6,751	$ 26	276,569	2,929	(272,773)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Exercise of common stock options (in shares)		21,493
Exercise of common stock options	60		60
Exchange of shares for warrants (in shares)		999,855
Exercise of common stock warrants	0	$ 1	(1)
Issuance of restricted stock units (in shares)		11,337
Issuance of common stock for convertible debt interest (in shares)		161,184
Issuance of common stock for convertible debt interest	572		572
Conversion of convertible debt (in shares)		22,644
Conversion of convertible debt	74		74
Stock-based compensation	720		720
Foreign currency translation	(885)			(885)
Net loss	$ (4,601)				(4,601)
Ending balance (in shares) at Mar. 31, 2021	27,035,842	27,035,842
Ending balance at Mar. 31, 2021	$ 2,691	$ 27	$ 277,994	$ 2,044	$ (277,374)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Cash flows from operating activities:
Net loss	$ (4,601)	$ (10,256)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	904	955
Amortization of deferred financing costs	133	154
Non-cash interest	446	356
Provision for (benefit from) doubtful accounts receivable	(18)	77
Stock-based compensation	720	401
Unrealized foreign exchange on intercompany payables	(545)	2,240
Changes in operating assets and liabilities:
Accounts receivable	(1,443)	1,430
Inventory	(236)	(1,522)
Prepaid expenses and other assets	(347)	(113)
Accounts payable and accrued expenses	678	15
Net cash used in operating activities	(4,309)	(6,263)
Cash flows from investing activities:
Purchases of property and equipment	(221)	(272)
Purchases of intangibles and other assets	(76)	(46)
Net cash used in investing activities	(297)	(318)
Cash flows from financing activities:
Proceeds from exercise of stock options	60	0
Payments of deferred financing costs	0	(206)
Net cash provided by/(used in) financing activities	60	(206)
Effect of exchange rate changes on cash	(6)	(95)
Net change in cash, cash equivalents and restricted cash	(4,552)	(6,882)
Cash, cash equivalents and restricted cash at beginning of year	37,200	30,921
Cash, cash equivalents and restricted cash at end of period	32,648	24,039
Supplemental disclosure of cash flow information:
Cash paid for interest	775	814
Cash paid for income taxes	4	7
Right-of-use assets recognized in exchange for lease obligations (non-cash)	$ 0	$ 36

Organization and Business Descr

Organization and Business Description	3 Months Ended
	Mar. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Business Description	Organization and Business Description Apollo Endosurgery, Inc. is a Delaware corporation with both domestic and foreign wholly-owned subsidiaries. Throughout these Notes, "Apollo" and the "Company" refer to Apollo Endosurgery, Inc. and its consolidated subsidiaries. Apollo is a medical technology company primarily focused on the development of next-generation, less invasive medical devices to advance gastrointestinal therapeutic endoscopy. The Company develops and distributes devices that are used by surgeons and gastroenterologists for a variety of procedures related to gastrointestinal conditions including closure of gastrointestinal defects, managing gastrointestinal complications and the treatment of obesity. The Company's core products include the OverStitch™ Endoscopic Suturing System, the OverStitch Sx™ Endoscopic Suturing System, X-Tack TM Endoscopic HeliX Tacking System (collectively "ESS") and the ORBERA® Intragastric Balloon ("IGB"). The Company has offices in the United Kingdom and Italy that oversee commercial activities outside the U.S. and a products manufacturing facility in Costa Rica. All other activities are managed and operated from facilities in Austin, Texas.

Significant Accounting Policies

Significant Accounting Policies	3 Months Ended
	Mar. 31, 2021
Accounting Policies [Abstract]
Significant Accounting Policies	Significant Accounting Policies (a) Basis of Presentation The Company prepared its interim condensed consolidated financial statements in conformity with accounting principles generally accepted in the United States of America ("GAAP"). They do not include all of the information and footnotes required by GAAP for complete financial statements. The accompanying condensed consolidated financial statements include the Company's accounts and the accounts of its wholly-owned subsidiaries. The Company has eliminated all intercompany balances and transactions. The Company has made estimates and judgments affecting the amounts reported in its condensed consolidated financial statements and the accompanying notes. The actual results that the Company experiences may differ materially from the Company's estimates. The accounting estimates that require the Company's most significant, difficult and subjective judgments include revenue recognition and inventory valuation. (b) Unaudited Interim Results In management's opinion, the unaudited financial information for the interim periods presented includes all adjustments necessary for a fair presentation of the results of operations, financial position, and cash flows. All adjustments are of a normal recurring nature unless otherwise disclosed. Revenues, expenses, assets and liabilities can vary during each quarter of the year. Therefore, the results and trends in these interim financial statements may not be the same as those for the full year. This interim information should be read in conjunction with the audited consolidated financial statements in the Company's Annual Report on Form 10-K for the year ended December 31, 2020. (c) Recent Accounting Pronouncements In March 2020, ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting

Concentrations

Concentrations	3 Months Ended
	Mar. 31, 2021
Risks and Uncertainties [Abstract]
Concentrations	ConcentrationsConsolidated financial instruments that potentially subject the Company to a concentration of credit risk principally consist of cash and cash equivalents and accounts receivable. At March 31, 2021, the Company's cash, cash equivalents and restricted cash are held in deposit accounts at five different banks totaling $32,648. The Company has not experienced any losses in such accounts, and management does not believe the Company is exposed to any significant credit risk. Management further believes that credit risk in the Company's accounts receivable is substantially mitigated by the Company's evaluation process, relatively short collection terms, and the high level of creditworthiness of its customers. The Company continually monitors the compliance of its customers with the Company's payment terms, but generally requires no collateral.The Company had no concentrations greater than 10% of the Company's net accounts receivable as of March 31, 2021. The Company had no single customer that comprised more than 10% of the Company's total revenues for the three months ended March 31, 2021 and 2020.

Inventory

Inventory	3 Months Ended
	Mar. 31, 2021
Inventory Disclosure [Abstract]
Inventory	Inventory Inventory consists of the following as of: March 31, 2021 December 31, 2020 (unaudited) Raw materials $ 2,745 $ 2,344 Work in progress 539 558 Finished goods 7,262 7,404 Total inventory $ 10,546 $ 10,306 Finished goods included $137 of consigned inventory at March 31, 2021.

Property, Equipment and Right-o

Property, Equipment and Right-of-Use Assets	3 Months Ended
	Mar. 31, 2021
Property, Plant and Equipment [Abstract]
Property, Equipment and Right-of-Use Assets	Property, Equipment and Right-of-Use Assets Property, equipment and right-of-use assets consists of the following: Depreciable Lives March 31, 2021 December 31, 2020 (unaudited) Equipment 5 years $ 7,476 $ 7,452 Right-of-use assets 1-5 years 4,028 4,031 Furniture, fixtures and tooling 4-8 years 2,375 2,156 Computer hardware 3-5 years 1,263 1,244 Leasehold improvements 3-7 years 1,743 1,744 Construction in process 470 466 17,355 17,093 Less accumulated depreciation (11,501) (10,872) Property, equipment and right-of-use assets $ 5,854 $ 6,221 The Company recorded depreciation expense of $429 and $458 for the three months ended March 31, 2021 and 2020, respectively. There were no impairment charges for the three months ended March 31, 2021 or 2020. The Company has operating leases for office space in Texas, the United Kingdom, and Italy, and for the manufacturing facility in Costa Rica. The Company also has various operating lease agreements for equipment and vehicles. As of March 31, 2021, the maturities of the Company's operating lease liabilities are as follows: 2021 $ 729 2022 570 2023 490 2024 425 2025 404 Thereafter 1,172 Total lease payments 3,790 Less imputed interest (997) Total operating lease liabilities $ 2,793 Operating lease liabilities of $565 are included in accrued expenses long-term liabilities

Accrued Expenses

Accrued Expenses	3 Months Ended
	Mar. 31, 2021
Payables and Accruals [Abstract]
Accrued Expenses	Accrued Expenses Accrued expenses consists of the following as of: March 31, 2021 December 31, 2020 (unaudited) Accrued employee compensation and expenses $ 3,350 $ 3,946 Accrued professional service fees 747 358 Lease liability 565 675 Accrued insurance and taxes 577 442 Accrued interest 350 616 Accrued returns and rebates 82 129 Other 1,236 1,191 Total accrued expenses $ 6,907 $ 7,357

Long-Term Debt

Long-Term Debt	3 Months Ended
	Mar. 31, 2021
Debt Disclosure [Abstract]
Long-Term Debt	Long-Term Debt Long-term debt consists of the following as of: March 31, 2021 December 31, 2020 (unaudited) Term loan facility $ 35,000 $ 35,000 PPP loan 2,824 2,824 Deferred interest 1,416 1,217 Deferred financing costs (1,130) (1,213) Less current portion (1,112) (636) Long-term debt $ 36,998 $ 37,192 Term Loan Facility In March 2019, the Company entered into a Term Loan Facility (the "Credit Agreement") with Solar Capital Ltd. ("Solar") to borrow $35,000. The Credit Agreement, as amended by the Seventh Amendment, provided a six-month extension of the interest only period and the maturity date if certain revenue milestones were achieved before December 2021. These revenue milestones were achieved as of March 31, 2021 and thus the Credit Agreement maturity was extended to March 1, 2025 with principal payments beginning in September 2022. The Credit Agreement bears interest at LIBOR, subject to a minimum floor, plus 7.5%. Principal payments are due on a straight-line basis after the interest-only period concludes. An additional 7.0% of the outstanding amount will be due at end of the loan term and an additional 5.5% fee will be due at the earlier of an Exit Event (as defined in the Credit Agreement) or if the Company achieves trailing twelve-month revenue of $100,000 before December 4, 2030. The Credit Agreement includes customary affirmative covenants, negative covenants and financial covenants, including a minimum liquidity requirement and minimum product revenues. In February 2021, the Eighth Amendment to the Credit Agreement established the revenue covenant requirements for 2021. As of March 31, 2021, the Company was in compliance with all financial covenants. PPP Loan In March 2020, the CARES Act was signed into law providing certain economic aid packages for qualified entities. In April 2020, the Company was granted a loan of $2,824 under the Small Business Administration’s (“SBA”) Paycheck Protection Program (“PPP”) established under the CARES Act. The Loan matures on February 27, 2023 and bears interest at a rate of 1.0% per annum with equal interest and principal payments beginning on September 27, 2021. Under the terms of the CARES Act, PPP loan recipients can apply for and be granted forgiveness for all or a portion of the loan granted under the PPP, with such forgiveness to be determined, subject to limitations, based on the use of the loan proceeds for payment of payroll costs, rent, utilities, and interest on debt. In December 2020, the Company applied for the forgiveness of the full amount of the $2,824 loan from the SBA. The Company will continue to include this PPP loan within long-term debt until confirmation of forgiveness is received from the SBA. Interest expense on the Company's long term debt was $1,058 and $1,041 for the three months ended March 31, 2021 and 2020, respectively. Principal payments of the Company's long-term debt are as follows: 2021 $ 627 2022 6,550 2023 14,314 2024 14,000 2025 2,333 Thereafter — $ 37,824

Convertible Debt

Convertible Debt	3 Months Ended
	Mar. 31, 2021
Debt Disclosure [Abstract]
Convertible Debt	Convertible Debt Convertible debt consists of the following as of: March 31, 2021 December 31, 2020 (unaudited) Convertible debt $ 20,445 $ 20,519 Deferred financing costs (1,082) (1,132) Total convertible debt $ 19,363 $ 19,387 In August 2019, the Company issued $20,000 aggregate principal amount of 6.0% convertible senior debentures due 2026 (the "Convertible Debt"), primarily to existing stockholders and officers of the Company. Interest on the Convertible Debt is payable semi-annually in shares of the Company's common stock on January 1 and July 1 of each year at a rate of 6.0% per year. The number of shares of common stock required to settle the amount of interest payable will be based on the volume-weighted average price ("VWAP") of the Company's common stock for the 10 consecutive trading days immediately preceding the applicable interest payment date. However, in the event that the trailing 10-trading day VWAP of the Company's common stock is less than $2.50 per share, interest accrued and payable for the applicable interest payment period will accrete to the principal amount then outstanding. The Convertible Debt will mature on August 12, 2026 unless earlier converted or repaid in accordance with its terms. In January 2021, the Company issued 161,184 shares of the Company's common stock to holders of the Convertible Debt in fulfillment of $572 of accrued interest as of December 31, 2020. As of March 31, 2021, accrued interest on the Convertible Debt is $350. The Convertible Debt converts, at the option of the holders, into shares of the Company's common stock at an initial conversion price of $3.25 per share, subject to adjustment. If the VWAP of the Company's common stock has been at least $9.75 (subject to adjustment) for at least 20 trading days during any 30 consecutive trading day period, the Company may force the conversion of all or any part of the outstanding principal amount of the Convertible Debt, accrued and unpaid interest and any other amounts then owing, subject to certain conditions. In February 2021, $74 of the Convertible Debt, including accrued interest was converted into 22,644 shares of common stock. Interest expense on the Convertible Debt was $357 and $378 for the three months ended March 31, 2021 and 2020, respectively.

Warrants

Warrants	3 Months Ended
	Mar. 31, 2021
Other Liabilities Disclosure [Abstract]
Warrants	WarrantsIn March 2021, 1,000,000 of pre-funded warrants were exercised into shares of common stock.

Stock-Based Compensation

Stock-Based Compensation	3 Months Ended
	Mar. 31, 2021
Share-based Payment Arrangement [Abstract]
Stock-Based Compensation	Stock-Based Compensation A summary of the stock option activity as of March 31, 2021 is presented below. Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term Aggregate Intrinsic Value Options outstanding, December 31, 2020 2,921,946 $ 3.86 7.6 years $ 1,664 Options granted 1,096,517 5.95 Options exercised (21,493) 2.81 Options forfeited (19,077) 4.56 Options outstanding, vested and expected to vest, March 31, 2021 3,977,893 $ 4.44 8.1 years $ 6,216 Options exercisable 1,389,467 $ 5.22 5.9 years $ 1,761 Shares subject to awards granted under the 2017 Plan which expire, are repurchased, or are canceled or forfeited will again become available for issuance under the 2017 Plan. The shares available will not be reduced by awards settled in cash or by shares withheld to satisfy tax withholding obligations. Only the net number of shares issued upon the exercise of options by means of a net exercise will be deducted from the shares available under the 2017 Plan. The fair value of stock option grants has been estimated at the date of grant using the Black-Scholes option pricing model with the following weighted average assumptions: Three Months Ended Risk free interest rate 1.0% Expected dividend yield —% Estimated volatility 81.0% Expected life 6.1 years Additional information regarding options is as follows: Three Months Ended Weighted-average grant date fair value of options granted during the period $ 4.12 Aggregate intrinsic value of options exercised during the period $ 57 The aggregate intrinsic value in the tables above represents the total pre-tax value of the options shown, calculated as the difference between the Company’s closing stock price on March 31, 2021 and the exercise prices of the options shown, multiplied by the number of in-the money options. This is the aggregate amount that would have been received by the option holders if they had all exercised their options on March 31, 2021 and sold the shares thereby received at the closing price of the Company’s common stock on that date. This amount changes based on the closing price of the Company’s common stock. No options were granted during the three months ended March 31, 2020. In March 2021, the Company awarded 848,733 stock options to the Company’s chief executive officer in connection with the commencement of his employment. The option grant will vest over a period of four years, with one-quarter of the shares underlying the option vesting on the first anniversary of the grant date and the remainder vesting in equal monthly installments thereafter. Unrecognized compensation expense related to unvested options was approximately $6,248 at March 31, 2021, with a remaining amortization period of 3.3 years. A summary of the restricted stock unit and performance stock unit activity under the Company's Equity Plans as of March 31, 2021 is presented below. Units Weighted Average Grant Date Fair Value Aggregate Intrinsic Value Unvested units, December 31, 2020 664,666 $ 2.55 $ 2,260 Restricted stock units and performance stock units granted 816,997 5.95 Restricted stock units vested (11,337) 6.58 Unvested units, March 31, 2021 1,470,326 $ 4.41 $ 8,101 In March 2021, the Company awarded 707,278 performance-based restricted stock units to the Company’s chief executive officer in connection with the commencement of his employment. The performance-based restricted stock units vest in four equal tranches upon the achievement of revenue for the trailing four quarters equal to $50,000, $65,000, $80,000, and $95,000, respectively.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2021
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The provision for income taxes for the three months ended March 31, 2021 and 2020 primarily consists of foreign income taxes. The Company has established a valuation allowance due to uncertainties regarding the realization of deferred tax assets based on the Company's lack of earnings history and potential limitations pursuant to changes in ownership under Internal Revenue Code Section 382. As of March 31, 2021, the Company has no unrecognized tax benefits or accrued interest or penalties associated with uncertain tax positions.

Net Loss Per Share

Net Loss Per Share	3 Months Ended
	Mar. 31, 2021
Earnings Per Share [Abstract]
Net Loss Per Share	Net Loss Per Share The basic and diluted net loss per common share presented in the condensed consolidated statements of operations and comprehensive loss is calculated by dividing net loss by the weighted-average number of common shares outstanding during the period, without consideration for common stock equivalents. Potentially dilutive shares, which include warrants for the purchase of common stock, convertible debt, restricted stock units, and options outstanding under the Company's equity incentive plans, are considered to be common stock equivalents and are only included in the calculation of diluted net loss per share when their effect is dilutive. Potentially dilutive securities that are not included in the calculation of diluted net loss per share attributable to common stockholders because to do so would be anti-dilutive are as follows (in common stock equivalent shares on a weighted-average basis): Three Months Ended March 31, 2021 2020 Warrants for common stock 15,617,335 1,204,371 Convertible debt 6,349,515 6,293,076 Common stock options 3,137,230 1,896,856 Restricted stock units 843,962 232,354 25,948,042 9,626,657

Fair Value Measurements

Fair Value Measurements	3 Months Ended
	Mar. 31, 2021
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements The carrying amounts of the Company's financial instruments, which primarily include cash, cash equivalents, and restricted cash, accounts receivable, accounts payable and accrued expenses, approximate their fair values due to their short maturities. The fair value of the Company's long-term debt and Convertible Debt is estimated by management to approximate $41,100 and $20,400, respectively at March 31, 2021. Management's estimates are based on comparisons of the characteristics of the Company's obligations, comparable ranges of interest rates on recently issued debt, and maturity. Such valuation inputs are considered a Level 3 measurement in the fair value valuation hierarchy. The accounting guidance defines fair value, establishes a consistent framework for measuring fair value and expands disclosure for each major asset and liability category measured at fair value on either a recurring or nonrecurring basis. Fair value is defined as an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions, the accounting guidance establishes a three-tier fair value hierarchy, which prioritizes the inputs used in measuring fair value as follows: Level 1: Observable inputs such as quoted prices in active markets; Level 2: Inputs, other than the quoted prices in active markets, that are observable either directly or indirectly; and Level 3: Unobservable inputs in which there is little or no market data, which require the reporting entity to develop its own assumptions.

Segment and Geographic Informat

Segment and Geographic Information	3 Months Ended
	Mar. 31, 2021
Segment Reporting [Abstract]
Segment and Geographic Information	Segment and Geographic InformationOperating segments are defined as components of an enterprise for which separate financial information is available and evaluated regularly by the chief operating decision maker, or decision-making group, in deciding how to allocate resources and in assessing performance. The Company globally manages the business within one reportable segment. Segment information is consistent with how management reviews the business, makes investing and resource allocation decisions and assesses operating performance. Product sales by product group and geographic market, based on the location of the customer, whether the U.S. or outside the U.S. ("OUS") for the periods shown were as follows: Three Months Ended March 31, 2021 Three Months Ended March 31, 2020 (unaudited) U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 5,395 $ 3,244 $ 8,639 62.4 % $ 3,755 $ 3,077 $ 6,832 63.7 % IGB 1,470 3,493 4,963 35.8 % 898 2,628 3,526 32.9 % Other 242 13 255 1.8 % 327 33 360 3.4 % Total revenues $ 7,107 $ 6,750 $ 13,857 100.0 % $ 4,980 $ 5,738 $ 10,718 100.0 % % Total revenues 51.3 % 48.7 % 46.5 % 53.5 % Total distributor sales were 43.7% and 34.0% of total OUS revenues for the three months ended March 31, 2021 and 2020, respectively. In March 2020, the Company ceased its direct sales operations in Brazil and entered into a distributor agreement with a third party. Sales in the next largest individual country outside the U.S. were 6.8% and 8.1% of total revenues for the three months ended March 31, 2021 and 2020, respectively. The following table represents property, equipment and right-of-use assets based on the physical location of the asset: March 31, 2021 December 31, 2020 (unaudited) U.S. $ 1,984 $ 2,149 Costa Rica 3,489 3,641 Other 381 431 Total property, equipment and right-of-use assets, net $ 5,854 $ 6,221

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2021
Accounting Policies [Abstract]
Organization and Business Description	Apollo Endosurgery, Inc. is a Delaware corporation with both domestic and foreign wholly-owned subsidiaries. Throughout these Notes, "Apollo" and the "Company" refer to Apollo Endosurgery, Inc. and its consolidated subsidiaries. Apollo is a medical technology company primarily focused on the development of next-generation, less invasive medical devices to advance gastrointestinal therapeutic endoscopy. The Company develops and distributes devices that are used by surgeons and gastroenterologists for a variety of procedures related to gastrointestinal conditions including closure of gastrointestinal defects, managing gastrointestinal complications and the treatment of obesity. The Company's core products include the OverStitch™ Endoscopic Suturing System, the OverStitch Sx™ Endoscopic Suturing System, X-Tack TM Endoscopic HeliX Tacking System (collectively "ESS") and the ORBERA® Intragastric Balloon ("IGB"). The Company has offices in the United Kingdom and Italy that oversee commercial activities outside the U.S. and a products manufacturing facility in Costa Rica. All other activities are managed and operated from facilities in Austin, Texas.
Recent Accounting Pronouncements	Recent Accounting Pronouncements In March 2020, ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting
Net Loss Per Share	The basic and diluted net loss per common share presented in the condensed consolidated statements of operations and comprehensive loss is calculated by dividing net loss by the weighted-average number of common shares outstanding during the period, without consideration for common stock equivalents. Potentially dilutive shares, which include warrants for the purchase of common stock, convertible debt, restricted stock units, and options outstanding under the Company's equity incentive plans, are considered to be common stock equivalents and are only included in the calculation of diluted net loss per share when their effect is dilutive.

Inventory (Tables)

Inventory (Tables)	3 Months Ended
	Mar. 31, 2021
Inventory Disclosure [Abstract]
Schedule of Inventory	Inventory consists of the following as of: March 31, 2021 December 31, 2020 (unaudited) Raw materials $ 2,745 $ 2,344 Work in progress 539 558 Finished goods 7,262 7,404 Total inventory $ 10,546 $ 10,306

Property, Equipment and Right_2

Property, Equipment and Right-of-Use Assets (Tables)	3 Months Ended
	Mar. 31, 2021
Property, Plant and Equipment [Abstract]
Schedule of Property and Equipment	Property, equipment and right-of-use assets consists of the following: Depreciable Lives March 31, 2021 December 31, 2020 (unaudited) Equipment 5 years $ 7,476 $ 7,452 Right-of-use assets 1-5 years 4,028 4,031 Furniture, fixtures and tooling 4-8 years 2,375 2,156 Computer hardware 3-5 years 1,263 1,244 Leasehold improvements 3-7 years 1,743 1,744 Construction in process 470 466 17,355 17,093 Less accumulated depreciation (11,501) (10,872) Property, equipment and right-of-use assets $ 5,854 $ 6,221
Operating Lease Maturity	As of March 31, 2021, the maturities of the Company's operating lease liabilities are as follows: 2021 $ 729 2022 570 2023 490 2024 425 2025 404 Thereafter 1,172 Total lease payments 3,790 Less imputed interest (997) Total operating lease liabilities $ 2,793

Accrued Expenses (Tables)

Accrued Expenses (Tables)	3 Months Ended
	Mar. 31, 2021
Payables and Accruals [Abstract]
Schedule of Accrued Expenses	Accrued expenses consists of the following as of: March 31, 2021 December 31, 2020 (unaudited) Accrued employee compensation and expenses $ 3,350 $ 3,946 Accrued professional service fees 747 358 Lease liability 565 675 Accrued insurance and taxes 577 442 Accrued interest 350 616 Accrued returns and rebates 82 129 Other 1,236 1,191 Total accrued expenses $ 6,907 $ 7,357

Long-Term Debt (Tables)

Long-Term Debt (Tables)	3 Months Ended
	Mar. 31, 2021
Debt Disclosure [Abstract]
Schedule of Long-term Debt	Long-term debt consists of the following as of: March 31, 2021 December 31, 2020 (unaudited) Term loan facility $ 35,000 $ 35,000 PPP loan 2,824 2,824 Deferred interest 1,416 1,217 Deferred financing costs (1,130) (1,213) Less current portion (1,112) (636) Long-term debt $ 36,998 $ 37,192
Schedule of Maturities of Long-term Debt	Principal payments of the Company's long-term debt are as follows: 2021 $ 627 2022 6,550 2023 14,314 2024 14,000 2025 2,333 Thereafter — $ 37,824

Convertible Debt (Tables)

Convertible Debt (Tables)	3 Months Ended
	Mar. 31, 2021
Debt Disclosure [Abstract]
Schedule of Convertible Debt	Convertible debt consists of the following as of: March 31, 2021 December 31, 2020 (unaudited) Convertible debt $ 20,445 $ 20,519 Deferred financing costs (1,082) (1,132) Total convertible debt $ 19,363 $ 19,387

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2021
Share-based Payment Arrangement [Abstract]
Schedule of Stock Option Activity	A summary of the stock option activity as of March 31, 2021 is presented below. Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term Aggregate Intrinsic Value Options outstanding, December 31, 2020 2,921,946 $ 3.86 7.6 years $ 1,664 Options granted 1,096,517 5.95 Options exercised (21,493) 2.81 Options forfeited (19,077) 4.56 Options outstanding, vested and expected to vest, March 31, 2021 3,977,893 $ 4.44 8.1 years $ 6,216 Options exercisable 1,389,467 $ 5.22 5.9 years $ 1,761
Schedule of Stock Options, Valuation Assumptions	The fair value of stock option grants has been estimated at the date of grant using the Black-Scholes option pricing model with the following weighted average assumptions: Three Months Ended Risk free interest rate 1.0% Expected dividend yield —% Estimated volatility 81.0% Expected life 6.1 years
Schedule of Other Stock Option Information	Additional information regarding options is as follows: Three Months Ended Weighted-average grant date fair value of options granted during the period $ 4.12 Aggregate intrinsic value of options exercised during the period $ 57
Schedule of Restricted Stock Unit Activity	A summary of the restricted stock unit and performance stock unit activity under the Company's Equity Plans as of March 31, 2021 is presented below. Units Weighted Average Grant Date Fair Value Aggregate Intrinsic Value Unvested units, December 31, 2020 664,666 $ 2.55 $ 2,260 Restricted stock units and performance stock units granted 816,997 5.95 Restricted stock units vested (11,337) 6.58 Unvested units, March 31, 2021 1,470,326 $ 4.41 $ 8,101

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	3 Months Ended
	Mar. 31, 2021
Earnings Per Share [Abstract]
Schedule of Antidilutive Securities Excluded from Computation of Diluted Loss Per Share	Potentially dilutive securities that are not included in the calculation of diluted net loss per share attributable to common stockholders because to do so would be anti-dilutive are as follows (in common stock equivalent shares on a weighted-average basis): Three Months Ended March 31, 2021 2020 Warrants for common stock 15,617,335 1,204,371 Convertible debt 6,349,515 6,293,076 Common stock options 3,137,230 1,896,856 Restricted stock units 843,962 232,354 25,948,042 9,626,657

Segment and Geographic Inform_2

Segment and Geographic Information (Tables)	3 Months Ended
	Mar. 31, 2021
Segment Reporting [Abstract]
Schedule of Product Sales by Product Group and Geographic Market	Product sales by product group and geographic market, based on the location of the customer, whether the U.S. or outside the U.S. ("OUS") for the periods shown were as follows: Three Months Ended March 31, 2021 Three Months Ended March 31, 2020 (unaudited) U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 5,395 $ 3,244 $ 8,639 62.4 % $ 3,755 $ 3,077 $ 6,832 63.7 % IGB 1,470 3,493 4,963 35.8 % 898 2,628 3,526 32.9 % Other 242 13 255 1.8 % 327 33 360 3.4 % Total revenues $ 7,107 $ 6,750 $ 13,857 100.0 % $ 4,980 $ 5,738 $ 10,718 100.0 % % Total revenues 51.3 % 48.7 % 46.5 % 53.5 %
Schedule of Long-Lived Assets by Geographic Area	The following table represents property, equipment and right-of-use assets based on the physical location of the asset: March 31, 2021 December 31, 2020 (unaudited) U.S. $ 1,984 $ 2,149 Costa Rica 3,489 3,641 Other 381 431 Total property, equipment and right-of-use assets, net $ 5,854 $ 6,221

Concentrations (Details)

Concentrations (Details) $ in Thousands	Mar. 31, 2021USD ($)bank	Dec. 31, 2020USD ($)	Mar. 31, 2020USD ($)	Dec. 31, 2019USD ($)
Risks and Uncertainties [Abstract]
Number of banks | bank	5
Cash and cash equivalents and restricted cash | $	$ 32,648	$ 37,200	$ 24,039	$ 30,921

Inventory (Details)

Inventory (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Inventory Disclosure [Abstract]
Raw materials	$ 2,745	$ 2,344
Work in progress	539	558
Finished goods	7,262	7,404
Total inventory	10,546	$ 10,306
Consigned inventory	$ 137

Property, Equipment and Right_3

Property, Equipment and Right-of-Use Assets (Details) - USD ($)	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Property, Plant and Equipment [Line Items]
Right-of-use assets	$ 4,028,000		$ 4,031,000
Property and equipment, gross	17,355,000		17,093,000
Less accumulated depreciation	(11,501,000)		(10,872,000)
Property, equipment and right-of-use assets	5,854,000		6,221,000
Depreciation	429,000	$ 458,000
Impairment charges	$ 0	$ 0
Minimum
Property, Plant and Equipment [Line Items]
Depreciable Lives, Right of use assets	1 year
Maximum
Property, Plant and Equipment [Line Items]
Depreciable Lives, Right of use assets	5 years
Equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 7,476,000		7,452,000
Depreciable Lives	5 years
Furniture, fixtures and tooling
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 2,375,000		2,156,000
Furniture, fixtures and tooling | Minimum
Property, Plant and Equipment [Line Items]
Depreciable Lives	4 years
Furniture, fixtures and tooling | Maximum
Property, Plant and Equipment [Line Items]
Depreciable Lives	8 years
Computer hardware
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 1,263,000		1,244,000
Computer hardware | Minimum
Property, Plant and Equipment [Line Items]
Depreciable Lives	3 years
Computer hardware | Maximum
Property, Plant and Equipment [Line Items]
Depreciable Lives	5 years
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 1,743,000		1,744,000
Leasehold improvements | Minimum
Property, Plant and Equipment [Line Items]
Depreciable Lives	3 years
Leasehold improvements | Maximum
Property, Plant and Equipment [Line Items]
Depreciable Lives	7 years
Construction in process
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 470,000		$ 466,000

Property, Equipment and Right_4

Property, Equipment and Right-of-Use Assets (Lease Maturity) (Details) $ in Thousands	Mar. 31, 2021USD ($)
Property, Plant and Equipment [Abstract]
2021	$ 729
2022	570
2023	490
2024	425
2025	404
Thereafter	1,172
Total lease payments	3,790
Less imputed interest	(997)
Total operating lease liabilities	$ 2,793

Property, Equipment and Right_5

Property, Equipment and Right-of-Use Assets (Lease Narrative) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Property, Plant and Equipment [Abstract]
Operating lease, current	$ 565		$ 675
Operating lease, current, financial statement location	us-gaap:AccountsPayableAndAccruedLiabilitiesCurrent		us-gaap:AccountsPayableAndAccruedLiabilitiesCurrent
Operating lease, noncurrent	$ 2,228
Operating lease, noncurrent, financial statement location	us-gaap:OtherLiabilitiesNoncurrent
Cash paid within operating cash flows for operating leases	$ 267	$ 294
Weighted average remaining lease term	4 years 9 months 18 days
Weighted average discount rate, percent	8.90%

Accrued Expenses (Details)

Accrued Expenses (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Payables and Accruals [Abstract]
Accrued employee compensation and expenses	$ 3,350	$ 3,946
Accrued professional service fees	747	358
Lease liability	565	675
Accrued insurance and taxes	577	442
Accrued interest	350	616
Accrued returns and rebates	82	129
Other	1,236	1,191
Total accrued expenses	$ 6,907	$ 7,357

Long-Term Debt (Schedule of Lon

Long-Term Debt (Schedule of Long-term Debt) (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020	Mar. 31, 2020
Debt Instrument [Line Items]
Deferred financing costs	$ (1,130)	$ (1,213)
Less current portion	(1,112)	(636)
Long-term debt	36,998	37,192
Deferred interest
Debt Instrument [Line Items]
Long-term debt	1,416	1,217
PPP loan
Debt Instrument [Line Items]
Long-term debt		2,824	$ 2,824
Term loan facility | Term loan facility
Debt Instrument [Line Items]
Long-term debt	$ 35,000	$ 35,000

Long-Term Debt (Narrative) (Det

Long-Term Debt (Narrative) (Details) - USD ($)	1 Months Ended	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Debt Instrument [Line Items]
Line of credit		$ 37,824,000
Interest expense		1,058,000	$ 1,041,000
PPP loan
Debt Instrument [Line Items]
Long-term debt			$ 2,824,000	$ 2,824,000
Interest rate			1.00%
Term loan facility | Term loan facility
Debt Instrument [Line Items]
Line of credit	$ 35,000,000
Percent of outstanding amount due	7.00%
Commitment fee percentage	5.50%
Twelve month revenue amount	$ 100,000
Long-term debt		$ 35,000,000		$ 35,000,000
Term loan facility | Term loan facility | LIBOR
Debt Instrument [Line Items]
Basis spread on variable rate	7.50%

Long-Term Debt (Schedule of Mat

Long-Term Debt (Schedule of Maturity of Long-term Debt) (Details) $ in Thousands	Mar. 31, 2021USD ($)
Debt Disclosure [Abstract]
2021	$ 627
2022	6,550
2023	14,314
2024	14,000
2025	2,333
Thereafter	0
Line of credit	$ 37,824

Convertible Debt (Schedule of C

Convertible Debt (Schedule of Convertible Debt) (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Deferred financing costs	$ (1,130)	$ (1,213)
Long-term debt	36,998	37,192
Convertible debt
Debt Instrument [Line Items]
Convertible debt	20,445	20,519
Deferred financing costs	(1,082)	(1,132)
Long-term debt	$ 19,363	$ 19,387

Convertible Debt (Narrative) (D

Convertible Debt (Narrative) (Details) $ / shares in Units, $ in Thousands	1 Months Ended			3 Months Ended
	Feb. 28, 2021USD ($)shares	Jan. 31, 2021shares	Aug. 31, 2019USD ($)d$ / shares	Mar. 31, 2021USD ($)	Mar. 31, 2020USD ($)	Dec. 31, 2020USD ($)
Debt Instrument [Line Items]
Accrued interest				$ 350		$ 616
Conversion of convertible debt	$ 74
Interest expense				1,058	$ 1,041
Common Stock
Debt Instrument [Line Items]
Issuance of common stock for convertible debt interest (in shares) | shares	22,644
Convertible debt
Debt Instrument [Line Items]
Proceeds from convertible debt			$ 20,000
Interest rate			6.00%
Stock price (USD per share) | $ / shares			$ 2.50
Issuance of common stock for convertible debt interest (in shares) | shares		161,184
Fulfillment of accrued interest						$ 572
Interest expense				$ 357	$ 378
Convertible debt | Conversion Ratio Less Than 2.50
Debt Instrument [Line Items]
Consecutive trading days (in days) | d			10
Convertible debt | Conversion Ratio Of 3.25
Debt Instrument [Line Items]
Consecutive trading days (in days) | d			30
Conversion price (USD per share) | $ / shares			$ 3.25
Stock price trigger (USD per share) | $ / shares			$ 9.75
Trading days (in days) | d			20

Warrants (Details)

Warrants (Details)	Mar. 31, 2021shares
Warrant
Class of Warrant or Right [Line Items]
Issued warrants to purchase shares, number of shares (in shares)	1,000,000

Stock-Based Compensation (Stock

Stock-Based Compensation (Stock Option Activity) (Details) - Stock Option - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Options
Options outstanding, beginning balance (in shares)			2,921,946
Options granted (in shares)	1,096,517	0
Options exercised (in shares)	(21,493)
Options forfeited (in shares)	(19,077)
Options vested and expected to vest (in shares)	3,977,893
Options exercisable (in shares)	1,389,467
Weighted Average Exercise Price
Weighted average exercise price, beginning balance (in USD per share)			$ 3.86
Options granted (in USD per share)	$ 5.95
Options exercised (in USD per share)	2.81
Options forfeited (in USD per share)	4.56
Options vested and expected to vest (in USD per share)	4.44
Options exercisable (in USD per share)	$ 5.22
Weighted Average Remaining Contractual Term
Weighted Average Remaining Contractual Term			7 years 7 months 6 days
Options vested and expected to vest	8 years 1 month 6 days
Options exercisable	5 years 10 months 24 days
Aggregate Intrinsic Value
Aggregate intrinsic value			$ 1,664
Options vested and expected to vest	$ 6,216
Options exercisable	$ 1,761

Stock-Based Compensation (Fair

Stock-Based Compensation (Fair Value of Stock Options) (Details) - Stock Option	3 Months Ended
	Mar. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk free interest rate	1.00%
Expected dividend yield	0.00%
Estimated volatility	81.00%
Expected life	6 years 1 month 6 days

Stock-Based Compensation (Addit

Stock-Based Compensation (Additional Information) (Details) $ / shares in Units, $ in Thousands	1 Months Ended	3 Months Ended
	Mar. 31, 2021USD ($)trancheshares	Mar. 31, 2021USD ($)$ / sharesshares	Mar. 31, 2020shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation expense related to unvested options	$ 6,248	$ 6,248
Remaining amortization period		3 years 3 months 18 days
Common stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted-average grant date fair value of options granted during period (in USD per share) | $ / shares		$ 4.12
Aggregate intrinsic value of options exercised during the period		$ 57
Options granted (in shares) | shares		1,096,517	0
Common stock options | Chief Executive Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares) | shares	848,733
Vesting period	4 years
Vesting percentage	25.00%
Restricted stock units and Performance shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Remaining amortization period		2 years
Restricted stock units and Performance shares | Chief Executive Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares) | shares	707,278
Number of tranches | tranche	4
Restricted stock units and Performance shares | Chief Executive Officer | Quarter one
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Amount vested	$ 50,000
Restricted stock units and Performance shares | Chief Executive Officer | Quarter two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Amount vested	65,000
Restricted stock units and Performance shares | Chief Executive Officer | Quarter three
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Amount vested	80,000
Restricted stock units and Performance shares | Chief Executive Officer | Quarter four
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Amount vested	95,000
Restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation expense related to unvested restricted stock units	1,726	$ 1,726
Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation expense related to unvested restricted stock units	$ 4,052	$ 4,052

Stock-Based Compensation(Restri

Stock-Based Compensation(Restricted Stock Units Activity) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2021	Dec. 31, 2020
Restricted stock units and Performance shares
Units
Restricted stock units and performance stock units granted (shares)	816,997
Weighted Average Grant Date Fair Value
Restricted stock units and performance stock units granted (USD per share)	$ 5.95
Restricted stock units
Units
Unvested Units (shares)	664,666
Restricted stock units vested (shares)	(11,337)
Unvested Units (shares)	1,470,326
Weighted Average Grant Date Fair Value
Unvested Units (USD per share)	$ 2.55
Restricted stock units vested (USD per share)	6.58
Unvested Units (USD per share)	$ 4.41
Aggregate Intrinsic Value
Aggregate Intrinsic Value	$ 8,101	$ 2,260

Income Taxes (Details)

Income Taxes (Details)	Mar. 31, 2021USD ($)
Income Tax Disclosure [Abstract]
Unrecognized tax benefits	$ 0
Accrued interest	0
Tax penalties	$ 0

Net Loss Per Share (Details)

Net Loss Per Share (Details) - shares	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of diluted loss per share (in shares)	25,948,042	9,626,657
Warrants for common stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of diluted loss per share (in shares)	15,617,335	1,204,371
Convertible debt
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of diluted loss per share (in shares)	6,349,515	6,293,076
Common stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of diluted loss per share (in shares)	3,137,230	1,896,856
Restricted stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of diluted loss per share (in shares)	843,962	232,354

Fair Value Measurements (Detail

Fair Value Measurements (Details) $ in Thousands	Mar. 31, 2021USD ($)
Fair Value Disclosures [Abstract]
Fair value of long-term debt	$ 41,100
Convertible debt, fair value	$ 20,400

Segment and Geographic Inform_3

Segment and Geographic Information (Segment Information) (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2021USD ($)segment	Mar. 31, 2020USD ($)
Segment Reporting [Abstract]
Number of reportable segments | segment	1
Revenue, Major Customer [Line Items]
Revenues	$ 13,857	$ 10,718
Segment Revenue | Product Risk
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	100.00%	100.00%
U.S.
Revenue, Major Customer [Line Items]
Revenues	$ 7,107	$ 4,980
U.S. | Segment Revenue | Product Risk
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	51.30%	46.50%
OUS
Revenue, Major Customer [Line Items]
Revenues	$ 6,750	$ 5,738
OUS | Segment Revenue | Product Risk
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	48.70%	53.50%
OUS | Distributor Sales | Product Risk
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	43.70%	34.00%
Non-US, Next Largest Single Country | Distributor Sales | Product Risk
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	6.80%	8.10%
ESS
Revenue, Major Customer [Line Items]
Revenues	$ 8,639	$ 6,832
ESS | Segment Revenue | Product Risk
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	62.40%	63.70%
ESS | U.S.
Revenue, Major Customer [Line Items]
Revenues	$ 5,395	$ 3,755
ESS | OUS
Revenue, Major Customer [Line Items]
Revenues	3,244	3,077
IGB
Revenue, Major Customer [Line Items]
Revenues	$ 4,963	$ 3,526
IGB | Segment Revenue | Product Risk
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	35.80%	32.90%
IGB | U.S.
Revenue, Major Customer [Line Items]
Revenues	$ 1,470	$ 898
IGB | OUS
Revenue, Major Customer [Line Items]
Revenues	3,493	2,628
Other
Revenue, Major Customer [Line Items]
Revenues	$ 255	$ 360
Other | Segment Revenue | Product Risk
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	1.80%	3.40%
Other | U.S.
Revenue, Major Customer [Line Items]
Revenues	$ 242	$ 327
Other | OUS
Revenue, Major Customer [Line Items]
Revenues	$ 13	$ 33

Segment and Geographic Inform_4

Segment and Geographic Information (Long-Lived Assets by Geographic Area) (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property, equipment and right-of-use assets, net	$ 5,854	$ 6,221
U.S.
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property, equipment and right-of-use assets, net	1,984	2,149
Costa Rica
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property, equipment and right-of-use assets, net	3,489	3,641
Other
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property, equipment and right-of-use assets, net	$ 381	$ 431