Vapotherm (VAPO) 10-Q 4 Nov 20 2020 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2020	Oct. 29, 2020
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q3
Entity Registrant Name	Vapotherm, Inc.
Entity Central Index Key	0001253176
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Common Stock, Shares Outstanding		25,661,162
Entity Shell Company	false
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity File Number	001-38740
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	46-2259298
Entity Address, Address Line One	100 Domain Drive
Entity Address, City or Town	Exeter
Entity Address, State or Province	NH
Entity Address, Postal Zip Code	03833
City Area Code	603
Local Phone Number	658-0011
Document Quarterly Report	true
Document Transition Report	false
Title of 12(b) Security	Common Stock, $0.001 par value per share
Trading Symbol	VAPO
Security Exchange Name	NYSE

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Current assets
Cash and cash equivalents	$ 139,015	$ 71,655
Accounts receivable, net	10,875	8,243
Inventories	25,029	9,137
Prepaid expenses and other current assets	4,895	4,066
Total current assets	179,814	93,101
Property and equipment, net	17,992	15,086
Restricted cash	1,853	1,852
Goodwill	571	588
Intangible assets, net	258	353
Deferred income tax assets	66	66
Other long-term assets	1,063	844
Total assets	201,617	111,890
Current liabilities
Accounts payable	6,252	3,375
Contract liabilities	279	137
Accrued expenses and other current liabilities	19,134	9,187
Short-term line of credit	4,495	3,491
Total current liabilities	30,160	16,190
Long-term loans payable, net	42,000	41,787
Other long-term liabilities	881	174
Total liabilities	73,041	58,151
Commitments and contingencies (Note 9)
Stockholders' equity
Preferred stock ($0.001 par value) 25,000,000 shares authorized; no shares issued and outstanding as of September 30, 2020 and December 31, 2019
Common stock ($0.001 par value) 175,000,000 shares authorized as of September 30, 2020 and December 31, 2019, 25,625,605 and 20,851,531 shares issued and outstanding as of September 30, 2020 and December 31, 2019, respectively	26	21
Additional paid-in capital	428,306	319,115
Accumulated other comprehensive income	3	44
Accumulated deficit	(299,759)	(265,441)
Total stockholders' equity	128,576	53,739
Total liabilities and stockholders’ equity	$ 201,617	$ 111,890

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) (Unaudited) - $ / shares	Sep. 30, 2020	Dec. 31, 2019
Statement Of Financial Position [Abstract]
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, shares authorized	25,000,000	25,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	175,000,000	175,000,000
Common stock, shares issued	25,625,605	20,851,531
Common stock, shares outstanding	25,625,605	20,851,531

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Income Statement [Abstract]
Net revenue	$ 30,559	$ 10,809	$ 84,826	$ 35,094
Cost of revenue	15,049	5,999	42,491	19,646
Gross profit	15,510	4,810	42,335	15,448
Operating expenses
Research and development	4,745	3,280	12,002	9,720
Sales and marketing	15,932	9,193	44,107	27,786
General and administrative	6,047	3,978	16,925	13,389
Total operating expenses	26,724	16,451	73,034	50,895
Loss from operations	(11,214)	(11,641)	(30,699)	(35,447)
Other (expense) income
Foreign currency gain (loss)	38	(28)	37	(37)
Interest income	42	242	227	658
Interest expense	(1,308)	(1,338)	(3,898)	(3,783)
Other			15
Net loss	(12,442)	(12,765)	(34,318)	(38,609)
Other comprehensive income (loss), net of tax:
Foreign currency translation adjustments	34	(72)	(41)	(70)
Total other comprehensive income (loss)	34	(72)	(41)	(70)
Total comprehensive loss	$ (12,408)	$ (12,837)	$ (34,359)	$ (38,679)
Net loss per share attributable to common stockholders - basic and diluted	$ (0.49)	$ (0.65)	$ (1.48)	$ (2.16)
Weighted-average number of shares used in calculating net loss per share, basic and diluted	25,578,328	19,531,153	23,192,703	17,854,730

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (Unaudited) - USD ($) $ in Thousands	Total	At-The-Market offering	Common Stock	Common StockAt-The-Market offering	Additional Paid-in Capital	Additional Paid-in CapitalAt-The-Market offering	Accumulated Other Comprehensive Income (Loss)	Accumulated Deficit
Beginning balance at Dec. 31, 2018	$ 51,561		$ 17		$ 265,926			$ (214,382)
Beginning balance, shares at Dec. 31, 2018			16,782,837
Issuance of common stock upon exercise of warrants	293				293
Issuance of common stock upon exercise of options, shares			268
Issuance of restricted stock	194				194
Issuance of restricted stock, shares			116,580
Stock-based compensation expense	1,935				1,935
Net loss	(12,964)							(12,964)
Ending balance at Mar. 31, 2019	41,019		$ 17		268,348			(227,346)
Ending balance, shares at Mar. 31, 2019			16,899,685
Beginning balance at Dec. 31, 2018	51,561		$ 17		265,926			(214,382)
Beginning balance, shares at Dec. 31, 2018			16,782,837
Net loss	(38,609)
Ending balance at Sep. 30, 2019	65,138		$ 21		318,178		$ (70)	(252,991)
Ending balance, shares at Sep. 30, 2019			20,801,613
Beginning balance at Mar. 31, 2019	41,019		$ 17		268,348			(227,346)
Beginning balance, shares at Mar. 31, 2019			16,899,685
Issuance of common stock upon exercise of warrants, shares			12,164
Issuance of common stock upon repayment of non-recourse loan	144				144
Issuance of common stock upon repayment of non-recourse loan, Shares			79,854
Issuance of common stock upon exercise of options	193				193
Issuance of common stock upon exercise of options, shares			122,497
Issuance of restricted stock	82				82
Issuance of restricted stock, shares			52,168
Stock-based compensation expense	789				789
Foreign currency translation adjustments	2						2
Net loss	(12,880)							(12,880)
Ending balance at Jun. 30, 2019	29,349		$ 17		269,556		2	(240,226)
Ending balance, shares at Jun. 30, 2019			17,166,368
Issuance of common stock, net	48,308		$ 4		48,304
Issuance of common stock, net, shares			3,570,750
Issuance of common stock upon exercise of options	37				37
Issuance of common stock upon exercise of options, shares			22,848
Issuance of restricted stock	64				64
Issuance of restricted stock, shares			41,647
Stock-based compensation expense	217				217
Foreign currency translation adjustments	(72)						(72)
Net loss	(12,765)							(12,765)
Ending balance at Sep. 30, 2019	65,138		$ 21		318,178		(70)	(252,991)
Ending balance, shares at Sep. 30, 2019			20,801,613
Beginning balance at Dec. 31, 2019	53,739		$ 21		319,115		44	(265,441)
Beginning balance, shares at Dec. 31, 2019			20,851,531
Issuance of common stock upon exercise of options	40				40
Issuance of common stock upon exercise of options, shares			24,687
Issuance of restricted stock	58				58
Issuance of restricted stock, shares			40,931
Stock-based compensation expense	1,447				1,447
Foreign currency translation adjustments	(71)						(71)
Net loss	(13,844)							(13,844)
Ending balance at Mar. 31, 2020	41,369		$ 21		320,660		(27)	(279,285)
Ending balance, shares at Mar. 31, 2020			20,917,149
Beginning balance at Dec. 31, 2019	53,739		$ 21		319,115		44	(265,441)
Beginning balance, shares at Dec. 31, 2019			20,851,531
Issuance of common stock under the Employee Stock Purchase Plan, shares			36,389
Net loss	(34,318)
Ending balance at Sep. 30, 2020	128,576		$ 26		428,306		3	(299,759)
Ending balance, shares at Sep. 30, 2020			25,625,605
Beginning balance at Mar. 31, 2020	41,369		$ 21		320,660		(27)	(279,285)
Beginning balance, shares at Mar. 31, 2020			20,917,149
Issuance of common stock, net	93,827	$ 9,784	$ 4	$ 1	93,823	$ 9,783
Issuance of common stock, net, shares			3,852,500	511,648
Issuance of common stock upon exercise of warrants, shares			41,066
Issuance of common stock under the Employee Stock Purchase Plan	359				359
Issuance of common stock under the Employee Stock Purchase Plan, shares			36,389
Issuance of common stock upon exercise of options	227				227
Issuance of common stock upon exercise of options, shares			99,206
Issuance of restricted stock	53				53
Issuance of restricted stock, shares			35,100
Stock-based compensation expense	1,377				1,377
Foreign currency translation adjustments	(4)						(4)
Net loss	(8,032)							(8,032)
Ending balance at Jun. 30, 2020	138,960		$ 26		426,282		(31)	(287,317)
Ending balance, shares at Jun. 30, 2020			25,493,058
Issuance of common stock upon exercise of warrants, shares			16,208
Issuance of common stock upon exercise of options	217				217
Issuance of common stock upon exercise of options, shares			80,020
Issuance of restricted stock	51				51
Issuance of restricted stock, shares			36,319
Stock-based compensation expense	1,756				1,756
Foreign currency translation adjustments	34						34
Net loss	(12,442)							(12,442)
Ending balance at Sep. 30, 2020	$ 128,576		$ 26		$ 428,306		$ 3	$ (299,759)
Ending balance, shares at Sep. 30, 2020			25,625,605

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Cash flows from operating activities
Net loss	$ (34,318)	$ (38,609)
Adjustments to reconcile net loss to net cash used in operating activities
Stock-based compensation expense	4,580	2,941
Depreciation and amortization	3,371	2,219
Provision for bad debts	251	77
Provision for inventory valuation	(428)	(602)
Loss on disposal of property and equipment	13	112
Amortization of discount on debt	190	171
Changes in operating assets and liabilities, net of acquisition:
Accounts receivable	(2,916)	616
Inventories	(15,468)	3,984
Prepaid expenses and other assets	(1,039)	528
Accounts payable	2,803	(743)
Contract liabilities	142	(31)
Accrued expenses and other current liabilities	10,710	807
Net cash used in operating activities	(32,109)	(28,530)
Cash flows from investing activities
Purchases of property and equipment	(5,944)	(3,132)
Acquisition of business, net of cash acquired		(1,560)
Net cash used in investing activities	(5,944)	(4,692)
Cash flows from financing activities
Proceeds from issuance of common stock	94,155	48,669
Common stock offering costs	(471)	(361)
Short-term line of credit	995	(260)
Proceeds from exercise of stock options and purchase of restricted stock	485	374
Proceeds on loans		10,500
Debt issuance costs		(322)
Net cash provided by financing activities	105,451	58,600
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(37)	(26)
Net increase in cash, cash equivalents and restricted cash	67,361	25,352
Cash, cash equivalents and restricted cash
Beginning of period	73,507	60,022
End of period	140,868	85,374
Supplemental disclosures of cash flow information
Interest paid during the period	3,670	3,563
Property and equipment purchases in accounts payable and accrued expenses	139	222
Issuance of warrants in conjunction with debt draw down		293
Issuance of common stock upon vesting of restricted stock	162	$ 340
At-The-Market offering
Cash flows from financing activities
Proceeds from issuance of common stock	9,927
Employee Stock Purchase Plan
Cash flows from financing activities
Proceeds from issuance of common stock under the Employee Stock Purchase Plan	$ 360

Description of Business

Description of Business	9 Months Ended
	Sep. 30, 2020
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Description of Business	1. Description of Business Vapotherm, Inc. (the “Company”) was founded in 1993 and reincorporated under the laws of the State of Delaware in 2013. Since inception, the Company has focused on the development and commercialization of its proprietary High Velocity Therapy products that are used to treat patients of all ages suffering from respiratory distress. The Company’s High Velocity Therapy delivers non-invasive ventilatory support by providing heated, humidified and oxygenated air at a high velocity to patients through a comfortable small-bore nasal interface. The Company’s Precision Flow systems, which use High Velocity Therapy, are clinically validated alternatives to, and address many limitations of, the current standard of care for the treatment of respiratory distress in a hospital setting. The Company offers four versions of its Precision Flow systems: Precision Flow Hi-VNI, Precision Flow Plus, Precision Flow Classic and Precision Flow Heliox. The Company generates revenue from sales of its Precision Flow systems and related disposable products utilized with its Precision Flow systems. The Company also generates revenue from sales of its Precision Flow system’s companion products, which include the Vapotherm Transfer Unit 2.0, the Q50 compressor and various adaptors. The Company offers different options to its hospital customers for acquiring Precision Flow capital units, ranging from the purchase of the Precision Flow capital units with payment in full at the time of purchase, to financed purchases of the Precision Flow capital units, to bundled discounts involving the placement of Precision Flow capital units for use by the customer at no upfront charge in connection with the customer’s ongoing purchase of disposable products. The Company sells Precision Flow systems to hospitals through a direct sales force in the United States and in the United Kingdom and through distributors in select other countries outside of the United States and United Kingdom. In addition, the Company utilizes clinical educators who are typically experienced users of high velocity therapy and who focus on medical education efforts to facilitate adoption and increase utilization. The Company is focused on physicians, respiratory therapists and nurses who work in acute hospital settings, including the emergency department (“ED”) and adult, pediatric and neonatal intensive care units (the “ICUs”). The Company’s relationship with these clinicians is particularly important, as it enables its products to follow patients through the care continuum. In March 2020, the World Health Organization declared a global pandemic related to the novel coronavirus (“COVID-19”). The Company’s high velocity therapy is a first-line therapy for treating respiratory distress, which is experienced by many COVID-19 patients. The Journal of the American Medical Association published data from mainland China in April 2020 suggesting that 19% of all COVID-19 patients experience respiratory distress and require some amount of respiratory support. The Company’s hospital customers around the world are using the Company’s technology to support the respiratory distress experienced by many COVID-19 patients so that they can triage their sickest patients using a limited number of ventilators. As a result, the Company has seen a significant increase in worldwide demand for its products from both new and existing accounts in the first nine months of 2020. Since inception, the Company has financed its operations primarily through public offerings of its common stock, private placements of its convertible preferred stock, sales of its Precision Flow systems and amounts borrowed under its credit facilities. The Company has devoted the majority of its resources to research and development activities related to its Precision Flow systems, including regulatory initiatives and sales and marketing activities. The Company has invested heavily in its sales and marketing function by increasing the number of sales representatives and clinical educators to facilitate adoption and increase utilization of its high velocity therapy products and expanded its digital marketing initiatives and medical education programs. The Company is subject to risks common to companies in the medical device industry, including, but not limited to, risks relating to the successful development and commercialization of its Precision Flow products, fluctuations in operating results and financial risks, protection of proprietary knowledge and patent risks, dependence on key personnel and collaborative partners, competition, technological and manufacturing risks, customer acceptance and demand, compliance with the Food and Drug Administration and other governmental regulations, management of growth and effectiveness of marketing by the Company and by third parties. On November 16, 2018, the Company completed an initial public offering of 4,600,000 shares of common stock, which included the full exercise by the underwriters of their option to purchase 600,000 shares of common stock, at a price of $14.00 per share, which raised net proceeds of $57.4 million after deducting the underwriting discount of $4.5 million and offering expenses of $2.5 million. On February 28, 2019, the Company acquired Solus Medical Ltd. (“Solus”), its United Kingdom based distributor. See Note 3 “Business Combinations” to these condensed consolidated financial statements for details of this transaction. In August 2019, the Company completed a public offering of 3,570,750 shares of common stock, which included the full exercise by the underwriters of their option to purchase 465,750 shares of common stock, at a price of $14.50 per share, which raised net proceeds of $48.3 million after deducting the underwriting discount of $3.1 million and offering expenses of $0.4 million. On December 20, 2019, the Company entered into an Open Market Sales Agreement (the “ATM Agreement”) with Jefferies LLC (“Jefferies”), under which the Company may offer and sell its common stock having aggregate sales proceeds of up to $50.0 million from time to time through Jefferies as its sales agents. During April 2020, the Company sold 511,648 shares of common stock pursuant to the ATM Agreement for gross proceeds of $10.2 million, or $9.8 million net of commissions and offering expenses. In May 2020, the Company completed a public offering of 3,852,500 shares of common stock, which included the full exercise by the underwriters of their option to purchase 502,500 shares of common stock, at a price of $26.00 per share, which raised net proceeds of $93.8 million after deducting the underwriting discount of $6.0 million and offering expenses of $0.3 million.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Basis of Presentation The condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”). The information included in this Quarterly Report on Form 10-Q should be read in conjunction with our audited consolidated financial statements and the accompanying notes included in our Annual Report on Form 10-K for the year ended December 31, 2019 (the “2019 Form 10-K”). Our accounting policies are described in the “ Notes to Consolidated Financial Statements ” in our 2019 Form 10-K and updated, as necessary, in this report. The year-end consolidated balance sheet data presented for comparative purposes was derived from our audited financial statements but does not include all disclosures required by U.S. GAAP. Principles of Consolidation These condensed consolidated financial statements include the financial statements of Solus, a wholly owned subsidiary of the Company based in the United Kingdom, which was acquired in the first quarter of 2019. All intercompany accounts and transactions have been eliminated upon consolidation. Segment Information Operating segments are defined as components of an enterprise for which separate discrete financial information is available and evaluated regularly by the chief operating decision maker in deciding how to allocate resources and in assessing performance. The Company globally manages the business within one reporting segment, Vapotherm, Inc. and two reporting units, Vapotherm and Solus. Segment information is consistent with how management reviews the business, makes investing and resource allocation decisions and assesses operating performance. The majority of the Company’s long-term assets are located in the United States. Long-term assets located outside the United States totaled $0.1 million as of each of September 30, 2020 and December 31, 2019. Use of Estimates The preparation of condensed consolidated financial statements in conformity with U.S. GAAP requires the Company to make judgments, assumptions, and estimates that affect the reported amounts of assets, liabilities, revenue and expenses, and the related disclosure of contingent assets and liabilities. The Company evaluates its estimates on an ongoing basis. The Company bases its estimates on historical experience and various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Significant estimates relied upon in preparing these condensed consolidated financial statements include calculation of stock-based compensation, valuation of warrants, fair values of acquired assets and liabilities, including goodwill and intangibles assets, realizability of inventories, allowance for bad debts, accrued expenses and the valuation allowances against deferred income tax assets. Actual results may differ from these estimates. Unaudited Interim Financial Information The accompanying condensed condensed condensed Reclassification Certain amounts in 2019 have been reclassified to conform to the presentation in 2020. None of the reclassifications had any impact to the Company’s results of operations. Concentrations of Credit Risk As of September 30, 2020, the Company’s financial instruments were comprised of cash and cash equivalents, restricted cash, accounts receivable, accounts payable and debt, the carrying amounts of which approximated fair value due to their short-term nature and market interest rates. All of the Company’s cash and cash equivalents are maintained at creditworthy financial institutions. At September 30, 2020, deposits exceed the amount of any federal depositary insurance provided. The Company extends credit to customers in the normal course of business but typically does not require collateral or any other security to support amounts due. Management performs ongoing credit evaluations of the Company’s customers. An allowance for potentially uncollectible accounts is provided based on history, economic conditions, and composition of the accounts receivable aging. In some cases, the Company makes allowances for specific customers based on these and other factors. Provisions for the allowance for doubtful accounts are recorded in general and administrative expenses in the accompanying condensed consolidated statements of comprehensive loss. Foreign Currency and Foreign Operations The functional currency of the Company is the currency of the primary economic environment in which the entity operates, which is the U.S. dollar. For our non-U.S. subsidiary that transacts in a functional currency other than the U.S. dollar, assets and liabilities are translated at current rates of exchange as of the balance sheet date. Income and expense items are translated at the average foreign currency exchange rates for the period. Adjustments resulting from the translation of the financial statements of its foreign operations into U.S. dollars are excluded from the determination of net loss and are recorded in accumulated other comprehensive income (loss), a separate component of stockholders’ equity. Realized foreign currency gains or losses arising from transactions denominated in foreign currencies are recorded in other (expense) income in the condensed consolidated statements of comprehensive loss. Cash, Cash Equivalents, and Restricted Cash The Company considers all highly liquid temporary investments purchased with original maturities of 90 days or less to be cash equivalents. The Company holds restricted cash related to certificates of deposits and collateral in relation to lease agreements. As of September 30, 2020, $0.4 million of our $140.9 million of cash, cash equivalents and restricted cash balance was located outside the United States. The following table presents the components of total cash, cash equivalents, and restricted cash as set forth in the Company’s condensed consolidated statements of cash flows: September 30, 2020 December 31, 2019 Cash and cash equivalents $ 139,015 $ 71,655 Restricted cash 1,853 1,852 Total cash, cash equivalents, and restricted cash $ 140,868 $ 73,507 Product Warranty The Company provides its customers with a standard one-year Balance at December 31, 2019 $ 225 Provisions for warranty obligations 659 Settlements (166 ) Balance at September 30, 2020 $ 718 Insurance Effective January 1, 2020, the Company was self-insured for certain obligations related to health insurance. The Company also purchases stop-loss insurance to protect itself from material losses. Judgments and estimates are used in determining the potential value associated with reported claims and for events that have occurred but have not been reported. The Company’s estimates consider expected claim experience and other factors. Receivables for insurance recoveries are recorded as assets, on an undiscounted basis. The Company’s liabilities are based on estimates, and, while the Company believes that its accruals are adequate, the ultimate liability may be significantly different from the amounts recorded. Changes in claims experience, the Company’s ability to settle claims or other estimates and judgments used by management could have a material impact on the amount and timing of expense for any period. Revenue Recognition The Company’s revenue is primarily derived from the sale of products, leases and services. Product revenue consists of capital equipment and single-use disposables that are shipped and billed to customers both domestically and internationally. The Company’s main capital equipment products are the Precision Flow Hi-VNI, Precision Flow Plus, Precision Flow Classic, Vapotherm Transfer Unit 2.0 and Q50 compressor. The Company’s main disposable products are single-use disposables and nasal interfaces, or cannulas, and adaptors. Lease revenue consists of two components which include capital equipment that the Company leases out to its customers and, in certain situations, an allocation from disposable revenue to other lease revenue upon the sale of disposable products in bundled arrangements involving the placement of Precision Flow capital units for use by the customer at no upfront charge in connection with the customer’s ongoing purchase of disposable products. Service revenue consists of fees associated with routine service of capital units and the sale of extended service contracts and preventative maintenance plans, which are purchased by a small portion of the Company’s customer base. In addition, the Company sells small quantities of component parts in the United States, United Kingdom and to third-party international service centers who provide service on Precision Flow capital units outside of the United States and United Kingdom. Freight revenue is based upon actual freight costs plus a percentage markup of such costs associated with the shipment of products domestically, and to a lesser extent, internationally, and is included in service revenue. Rebates and fees consist of contractually obligated administrative fees and percentage-of-sales rebates paid to Group Purchasing Organizations (“GPOs”), Integrated Delivery Networks (“IDNs”) and distributor partners and accounted for as a reduction of service revenue. Under the Financial Accounting Standard Board’s (“FASB”) Accounting Standards Codification (“ASC”) 606, Revenue from Contracts with Customers (“ASC 606”), revenue is recognized when a customer obtains control of promised goods or services, in an amount that reflects the consideration which the Company expects to receive in exchange for those goods or services. To determine revenue recognition for arrangements that an entity determines are within the scope of ASC 606, the Company performs the following five steps: (i) identify the contract(s) with a customer; (ii) identify the performance obligations in the contract; (iii) determine the transaction price; (iv) allocate the transaction price to the performance obligations in the contract; and (v) recognize revenue when (or as) the entity satisfies a performance obligation. The Company only applies the five-step model to contracts when it is probable that the entity will collect the consideration it is entitled to in exchange for the goods or services it transfers to the customer. At contract inception, once the contract is determined to be within the scope of ASC 606, the Company assesses the goods or services promised within each contract and assesses whether each promised good or service is distinct and determines those that are performance obligations. The Company then recognizes as revenue the amount of the transaction price that is allocated to the respective performance obligation when (or as) the performance obligation is satisfied. Sales, value-added, and other taxes collected on behalf of third parties are excluded from revenue. The Company’s standard payment terms are generally 30 days from the date of sale. Contracts with customers may contain multiple performance obligations. For such arrangements, the transaction price is allocated to each performance obligation based on the estimated relative stand-alone selling prices of the promised products or services underlying each performance obligation. The Company determines stand-alone selling prices based on the price at which the performance obligation is sold separately. If the stand-alone selling price is not observable through past transactions, the Company estimates the stand-alone selling price taking into account available information such as market conditions and internally approved pricing guidelines related to the performance obligations. When determining the transaction price of a contract, an adjustment is made if payment from a customer occurs either significantly before or significantly after performance, resulting in a significant financing component. Applying the practical expedient in paragraph ASC 606-10-32-18, the Company does not assess whether a significant financing component exists if the period between when the Company performs its obligations under the contract and when the customer pays is one year or less. None of the Company’s contracts contained a significant financing component during the nine months ended September 30, 2020 or 2019. The Company’s contracts with its customers have a duration of less than one year. Therefore, the Company has elected to apply a practical expedient and recognizes the incremental costs of obtaining contracts as an expense. These costs are included in sales and marketing expense in the accompanying condensed consolidated statements of comprehensive loss. Lease Revenue The Company also enters into agreements to lease its capital equipment. For such sales, the Company accounts for revenue under ASC 840, Leases, and assesses and classifies these transactions as sales-type or operating leases based on whether the lease transfers ownership of the equipment to the lessee by the end of the lease term. This criterion is met in situations in which the lease agreement provides for the transfer of title at or shortly after the end of the lease term. Equipment included in arrangements including transfer of title are accounted for as sales-type leases and the Company recognizes the total value of the lease payments due over the lease term to revenue at the inception of the lease. The Company records the current value of future lease payments under prepaid expenses and other current assets in the accompanying condensed consolidated balance sheets; these amounts totaled $1.7 and $0.9 million at September 30, 2020 and December 31, 2019, respectively. Equipment included in arrangements that do not include the transfer of title, nor any of the capital lease criteria, are accounted for as operating leases and revenue is recognized on a straight-line basis as it becomes receivable monthly over the term of the lease. The Company also enters into agreements involving the placement of Precision Flow capital units for use by the customer at no upfront charge in connection with the customer’s ongoing purchase of disposable products. In these bundled arrangements, revenue recognized for the sale of the disposables is allocated between disposable revenue and other lease revenue based on the estimated relative stand-alone selling prices of the individual performance obligations. Shipping and Handling Costs Amounts billed to customers for shipping and handling are included in service revenue. Shipping and handling costs are included in costs of sales. The total costs of shipping and handling for the three months ended September 30, 2020 and 2019 was $0.6 and $0.2 million, respectively. Shipping and handling costs for the nine months ended September 30, 2020 and 2019 totaled $1.7 and $0.7 million, respectively. Sales and Value-Added Taxes When required by local jurisdictions, the Company bills its customers for sales tax and value-added tax calculated on each sales invoice and records a liability for the sales and value-added tax payable, which is included in accrued expenses and other liabilities in the condensed consolidated balance sheets. Sales tax and value-added tax billed to a customer are not included in the Company’s revenue. Timing and Amount of Revenue Recognition The Company recognizes revenue on product sales and service of its capital equipment and product sales of disposables to its end users in the United States and United Kingdom and to its distribution partners in other international markets. In each instance, revenue is generally recognized when the customer obtains control of the Company’s product, which generally occurs at a point in time upon shipment based on the contractual shipping terms of a contract. Product and service revenue is measured as the amount of consideration the Company expects to receive in exchange for transferring products or services to a customer. To the extent the transaction price includes variable consideration, the Company estimates the amount of variable consideration that should be included in the transaction price utilizing the expected value amount method to which the Company expects to be entitled. As such, revenue on sales is recorded net of prompt pay discounts and payments made to GPOs, IDNs and distributors. Variable consideration is included in the transaction price if, in the Company’s judgment, it is probable that a significant future reversal of cumulative revenue under the contract will not occur. Determination of whether to include estimated amounts in the transaction price is based largely on an assessment of the Company’s anticipated performance and all information (historical, current and forecasted) that is reasonably available. The Company believes that the estimates it has established are reasonable based upon current facts and circumstances. Applying different judgments to the same facts and circumstances could result in different estimates. Stock-Based Compensation The Company maintains an equity incentive plan to provide long-term incentives for employees, consultants, and members of the board of directors. The plan allows for the issuance of non-statutory and incentive stock options, restricted stock, unrestricted stock, stock units, including restricted stock units, and stock appreciation rights to employees, consultants and non-employee directors. The Company recognizes stock-based compensation expense for awards of equity instruments to employees and non-employees based on the grant date fair value of those awards in accordance with ASC Topic 718, Stock Compensation (“ASC 718”). ASC 718 requires all equity-based compensation awards, including grants of restricted shares and stock options, to be recognized as expense in the condensed consolidated statements of comprehensive loss based on their grant date fair values. The fair value of each option grant is estimated on the grant date using the Black-Scholes option pricing model. The fair value is then amortized on a straight-line basis over the requisite service period of the awards, which is generally the vesting period. For performance-based awards, the related compensation cost is amortized over the performance period on an accelerated attribution basis. Compensation cost associated with performance awards is based on fair value on the date of grant and the number of units expected to be earned after assessing the probability that certain performance criteria will be met and the associated targeted payout level that is forecasted will be achieved. Cumulative adjustments are recorded each quarter to reflect estimated outcomes of the performance-related conditions until the results are determined and settled. Use of a valuation model requires management to make certain assumptions with respect to selected model inputs, including the expected life (weighted average period of time that the options granted are expected to be outstanding), the volatility of the Company’s common stock and an assumed risk-free interest rate. Expected volatility is calculated based on historical volatility of a group of publicly traded companies that the Company considers a peer group. The expected life is estimated using the simplified method for “plain vanilla” options. The risk-free interest rate is based on U.S. Treasury rates with a remaining term that approximates the expected life assumed at the date of grant. No dividend yield is assumed as the Company does not pay, and does not expect to pay, dividends on its common stock. The Company estimates forfeitures based on historical experience with pre-vested forfeitures. To the extent actual forfeitures differ from the estimate, the difference is recorded to compensation expense in the period of the forfeiture. The Company recognizes stock-based expense for shares issued pursuant to its 2018 Employee Stock Purchase Plan (“ESPP”) on a straight-line basis over the related offering period. The Company estimates the fair value of shares to be issued under the ESPP based on a combination of options valued using the Black-Scholes option pricing model. The expected life is determined based on the contractual term. D ividend yield and forfeiture rates are estimated in a manner similar to option grants described above and expected volatility is based on the Company’s historical volatility . Income Tax The Company accounts for income taxes using the asset and liability method, which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been recognized in the condensed consolidated financial statements or in the Company’s tax returns. Deferred taxes are determined based on the difference between the financial reporting and tax basis of assets and liabilities using enacted tax rates in effect in the years in which the differences are expected to reverse. Changes in deferred tax assets and liabilities are recorded in the provision for income taxes. The Company assesses the likelihood that its deferred tax assets will be recovered from future taxable income and, to the extent it believes, based upon the weight of available evidence, that it is more likely than not that all or a portion of deferred tax assets will not be realized, a valuation allowance is established through a charge to income tax expense. Potential for recovery of deferred tax assets is evaluated by estimating the future taxable profits expected and considering prudent and feasible tax planning strategies. The Company accounts for uncertainty in income taxes recognized in the condensed consolidated financial statements by applying a two-step process to determine the amount of tax benefit to be recognized. First, the tax position must be evaluated to determine the likelihood that it will be sustained upon external examination by the taxing authorities. If the tax position is deemed more likely than not to be sustained, the tax position is then assessed to determine the amount of benefit to recognize in the condensed consolidated financial statements. The amount of the benefit that may be recognized is the largest amount that has a greater than 50% likelihood of being realized upon ultimate settlement. The provision for income taxes includes the effects of any resulting tax reserves, or unrecognized tax benefits, that are considered appropriate as well as the related net interest and penalties. The Company’s major tax jurisdictions are the United States, New Hampshire and the United Kingdom. There is no provision or benefit for income taxes for the three or nine months ended September 30, 2020 or 2019 because the Company has historically incurred operating losses and maintains a full valuation allowance against its United States net deferred tax assets. Utilization of the net operating loss and tax credit carryforwards may be subject to a substantial annual limitation under Sections 382 and 383 of the Internal Revenue Code of 1986, as amended (the “Code”) due to ownership change limitations that have occurred previously or that could occur in the future. These ownership changes may limit the amount of net operating loss and tax credit carryforwards that can be utilized to offset future taxable income and reduce taxes, respectively. The Company has not currently completed an evaluation of ownership changes through September 30, 2020 or December 31, 2019 to assess whether utilization of the Company’s net operating loss and tax credit carryforwards would be subject to an annual limitation under Sections 382 and 383 of the Code. To the extent an ownership change is determined to have occurred under Sections 382 and 383 of the Code, the net operating loss and tax credit carryforwards may be subject to limitation. Recently Issued Accounting Pronouncements As an emerging growth company (“EGC”), the Jumpstart Our Business Startups Act (the “JOBS Act”) allows the Company to delay adoption of new or revised accounting pronouncements applicable to public companies until such pronouncements are made applicable to private companies. The Company has elected to use the adoption dates applicable to private companies. As a result, the Company’s consolidated financial statements may not be comparable to the financial statements of issuers who are required to comply with the effective date for new or revised accounting standards that are applicable to public companies. The Company expects it will no longer qualify as an EGC as of December 31, 2020 and, at that time, will begin to adopt certain accounting pronouncements at dates applicable to public companies. Leases (Topic 842): In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) (“ASU 2016-02”). ASU 2016-02 establishes a comprehensive new lease accounting model. The new standard clarifies the definitions of a lease, requires a dual approach to lease classification similar to current lease classifications, and causes lessees to recognize leases on the balance sheet as a lease liability with a corresponding right-of-use asset for leases with a lease term of more than twelve months. In July 2018, the FASB issued ASU No. 2018-11 Leases (Topic 842) (“ASU 2018-11”) which provided another transition method in addition to the existing transition method by allowing entities to initially apply the new leases standard at the adoption date. In June 2020, the FASB issued ASU 2020-05, Revenue from Contracts with Customers (Topic 606) and Leases (Topic 842), which defers the effective date for ASU 2016-02 to annual periods beginning after December 15, 2021 and interim periods beginning after December 15, 2022 for private companies or EGCs following private company adoption dates. The standard was effective for public companies for periods beginning after December 31, 2018. The new standard originally required a modified retrospective transition for capital or operating leases existing at or entered into after the beginning of the earliest comparative period presented in the financial statements, but it does not require transition accounting for leases that expire prior to the date of the initial application. The Company expects to adopt the new standard in the fourth quarter of 2020 with an effective date of January 1, 2020. The Company is in the process of adopting the new standard, including evaluating the changes that will be required under this standard to its future financial reporting and disclosures, and the Company has designed and implemented related processes and controls to address these changes. The Company expects the most significant effects of adoption to relate to (1) the recognition of new right-of-use assets and lease liabilities on the balance sheet for the Company’s facilities and certain other operating leases; and (2) the need to provide new disclosures about the Company’s leasing activities related to the amount, timing and uncertainty of cash flows arising from leases. Credit Losses (Topic 326): In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments (“ASU 2016-13”). This standard requires that credit losses be reported using an expected losses model rather than the incurred losses model that is currently used and establishes additional disclosures related to credit risks. In November 2019, the FASB issued ASU 2019-10, Financial Instruments-Credit Losses (Topic 326), Derivative and Hedging (Topic 815) and Leases (Topic 842), which defers the effective date for ASU 2016-13 to interim and annual periods beginning after December 15, 2022 for private companies, EGCs following private company adoption dates, or public entities meeting the definition of smaller reporting companies as of the date of issuance of this update. The Company has not yet determined the effects, if any, that the adoption of ASU 2016-13 may have on its financial position, results of operations, cash flows, or disclosures.

Business Combinations

Business Combinations	9 Months Ended
	Sep. 30, 2020
Business Combinations [Abstract]
Business Combinations	3. Business Combinations On February 28, 2019, the Company completed the acquisition of all outstanding equity securities of Solus, The following table summarizes the purchase price allocation that includes the fair values of the separately identifiable assets acquired and liabilities assumed as of February 28, 2019: Cash $ 466 Accounts receivable 411 Inventory 492 Prepaids and other assets 3 Property and equipment 1 Goodwill 592 Intangible assets 455 Total assets acquired 2,420 Accounts payable and accrued expenses (241 ) Contract liabilities (75 ) Deferred taxes (78 ) Total liabilities assumed (394 ) Total purchase price $ 2,026 The excess of purchase consideration over the fair value of net tangible and identifiable intangible assets acquired was recorded as goodwill. The fair values assigned to tangible and identifiable intangible assets acquired and liabilities assumed are based on management’s estimates and assumptions. In determining the purchase price allocation, the Company considered, among other factors, the opportunity provided by a customer agreement with the National Health Service. The fair value of the intangible assets associated with this agreement were estimated using a discounted cash flow method with the application of the multi-period excess earnings method. Under this method, an intangible asset’s fair value is equal to the present value of the incremental after-tax cash flows attributable to only the subject intangible assets after deducting contributory asset charges. An income and expenses forecast was built based upon specific intangible asset revenue and expense estimates. The rate used to discount the estimated future net cash flows to their present values for each intangible asset was based upon a weighted average cost of capital calculation. The discount rate was determined after consideration of market rates of return on debt and equity capital, the weighted average return on invested capital and the risk associated with achieving forecasted sales related to the assets acquired from Solus. The total weighted average amortization period for the intangible assets is approximately 3.83 years. The intangible assets are being amortized on a straight-line basis, which is consistent with the pattern that the economic benefits of the intangible assets are expected to be utilized based upon estimated cash flows generated from such assets. Goodwill associated with the acquisition was primarily attributable to the market expansion opportunity in the United Kingdom. The goodwill attributable to the United Kingdom jurisdiction is not deductible for tax purposes. The Company has included the financial results of Solus in the condensed consolidated financial statements from the date of acquisition. The transaction costs associated with the acquisition were approximately $0.2 million and were recorded in general and administrative expense as incurred during 2019. Pro Forma Financial Information The following unaudited pro forma information for the three and nine months ended September 30, 2019 presents consolidated information as if the Solus acquisition occurred on January 1, 2019, which was the first day of the Company’s fiscal year 2019: Three Months Ended September 30, Nine Months Ended September 30, 2019 2019 Net revenue $ 10,809 $ 35,331 Net loss $ (12,765 ) $ (38,553 ) Net loss per share, basic $ (0.65 ) $ (2.16 )

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2020
Fair Value Disclosures [Abstract]
Fair Value Measurements	4. Fair Value Measurements In accordance with ASC 820, Fair Value Measurements and Disclosures, the Company generally defines fair value as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date (exit price). The Company uses a three-tier fair value hierarchy, which classifies the inputs used in measuring fair values. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level 1 measurements), and the lowest priority to unobservable inputs (Level 3 measurements). The three levels of the fair value hierarchy are described below: • Level 1 – inputs are quoted prices (unadjusted) in active markets for identical assets or liabilities that the reporting entity has the ability to access at the measurement date. • Level 2 – inputs other than quoted prices included within Level 1 that are observable for the asset or liability, either directly or indirectly. If the asset or liability has a specified (contractual) term, a Level 2 input must be observable for substantially the full term of the asset or liability. • Level 3 – unobservable inputs for the asset or liability in which there is little, if any, market activity for the asset or liability at the measurement date. The Company’s cash equivalents primarily consist of money market deposits, which totaled approximately $123.2 million at September 30, 2020 and are valued based on Level 1 of the fair value hierarchy. As described in Note 8 “Debt”, during 2019, the Company granted warrants to purchase 19,789 shares of common stock in connection with an amendment to its financing arrangement. These equity-classified warrants were valued using the Black-Scholes pricing model, which falls within Level 3 of the fair value hierarchy. The assumptions used in the Black-Scholes pricing model were as follows at the date of grant: Expected dividend yield 0.0 % Risk free interest rate 2.4 % Expected stock price volatility 60.9 % Expected term (years) 10.0

Accounts Receivable

Accounts Receivable	9 Months Ended
	Sep. 30, 2020
Receivables [Abstract]
Accounts Receivable	5. Accounts Receivable Accounts receivable by customer location consists of the following: September 30, 2020 December 31, 2019 United States $ 7,530 $ 5,574 International 3,883 2,908 Total accounts receivable 11,413 8,482 Less: Allowance for doubtful accounts (538 ) (239 ) Accounts receivable, net of allowance for doubtful accounts $ 10,875 $ 8,243 No individual customer accounted for 10% or more of revenue for the three or nine months ended September 30, 2020 or 2019. No individual customers accounted for 10% or more of total accounts receivable at either September 30, 2020 or December 31, 2019.

Inventories

Inventories	9 Months Ended
	Sep. 30, 2020
Inventory Disclosure [Abstract]
Inventories	6. Inventories Inventories consist of the following: September 30, 2020 December 31, 2019 Component parts $ 10,918 $ 4,948 Finished goods 14,111 4,189 Total inventories $ 25,029 $ 9,137

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2020
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	7. Goodwill and Intangible Assets The changes in the carrying amount of goodwill and intangible assets during 2020 are as follows: Goodwill Intangible Assets Balance at December 31, 2019 $ 588 $ 353 Acquired during the period - - Amortization - (85 ) Foreign currency exchange rate changes (17 ) (10 ) Balance at September 30, 2020 $ 571 $ 258 The following table presents a summary of previously acquired intangible assets: As of September 30, 2020 Period of amortization Gross Carrying Amount Accumulated Amortization Customer agreements 3.83 $ 440 $ (182 ) Total identifiable intangible assets $ 440 $ (182 )

Debt

Debt	9 Months Ended
	Sep. 30, 2020
Debt Disclosure [Abstract]
Debt	8. Debt Revolving Credit Line On November 16, 2016, the Company entered a Business Financing Agreement (the “Revolver Agreement”) with Western Alliance Bank, an Arizona corporation, which replaced its then-existing revolving line of credit. The Revolver Agreement made available $7.0 million of revolving credit upon the closing date. Availability under the Revolver Agreement is calculated based upon 80% of the eligible receivables (net of pre-paid deposits, pre-billed invoices, other offsets, and contras related to each specific account debtor). The original maturity date under the Revolver Agreement was September 30, 2018. The Company refinanced the Revolver Agreement in April 2018 (the “Amended Revolver Agreement”), increasing the line of credit to $7.5 million and extending the maturity date to September 30, 2020. The principal is due upon maturity. On March 22, 2019, the Company entered into an amendment to the Amended (as amended, the “First Amended Revolver Agreement”), which increased the allowable permitted indebtedness under the First Amended Revolver Agreement in connection with the Company’s credit card program from $0.3 million to $0.5 million. On July 7, 2020, the Company entered into a second amendment to the Amended Revolver Agreement (as amended, the “Second Amended Revolver Agreement”), which, under certain circumstances, reduced the amount of funds required to be held on deposit with Western Alliance Bank. On September 29, 2020, the Company entered into a third amendment to the Amended Revolver Agreement (as amended, the “Third Amended Revolver Agreement”), which extended the maturity date to February 28, 2023. Under the Third Amended Revolver Agreement, interest is required to be paid monthly on the outstanding balance at the Wall Street Journal Prime Rate in effect from time to time, subject to a floor of 3.25%. At September 30, 2020 the interest rate was 3.25%. The outstanding balance under the Third Amended Revolver Agreement was $4.5 million at September 30, 2020 and there was $0.8 million remaining availability based on eligible receivables. At December 31, 2019, the interest rate was 6.50%. The outstanding balance under the Third Amended Revolver Agreement The Third Amended Revolver Agreement is secured by substantially all of the Company’s assets, excluding intellectual property. As discussed in Note 15 “Subsequent Events,” the Company fully repaid and terminated the Third Amended Revolver Agreement on October 21, 2020. Term Loans On April 6, 2018, the Company entered into a Credit Agreement and Guaranty (the “Credit Agreement and Guaranty”) with Perceptive Credit Holdings II, LP (“Perceptive”). Pursuant to the Credit Agreement and Guaranty, a total of $42.5 million was available in three tranches. The first tranche was drawn down in the amount of $20.0 million on the closing date, April 6, 2018, and was used to repay a former loan agreement in full. On July 20, 2018, pursuant to the Credit Agreement and Guaranty, the Company drew down the second tranche of $10.0 million. In connection with this draw down, the Company granted Perceptive warrants to purchase 18,846 shares of Series D preferred stock which were converted into warrants to purchase shares of common stock at the time of the initial public offering. The warrants had an exercise price of $15.92 per share, were fully vested upon issuance, were exercisable at the option of the holder, in whole or in part, and would have expired in July 2028. On September 27, 2018, the Company entered into the first amendment to the Credit Agreement and Guaranty (as amended, the “Amended Credit Agreement and Guaranty”) with Perceptive. Pursuant to the Amended Credit Agreement and Guaranty, the Company was permitted to draw the final $12.5 million of availability at any time through March 31, 2019 and the minimum 2018 revenue requirement of $43.2 million that was required to draw down the final tranche was eliminated. Concurrently with the closing of the Amendment, the Company drew down $2.0 million of the remaining $12.5 million available. In connection with this draw down, the Company granted to Perceptive warrants to purchase 3,769 shares of its Series D preferred stock which were converted into warrants to purchase shares of common stock at the time of the initial public offering. The warrants ha d an exercise price of $15.92 per share, were fully vested upon issuance, were exercisable at the option of the holder, in whole or in part, and would have expire d in September 2028 . On March 22, 2019, the Company drew the remaining $10.5 million of availability under the Amended Credit Agreement and Guaranty. In connection with this draw down, the Company granted Perceptive warrants to purchase 19,789 shares of common stock. The warrants had an exercise price of $15.92 per share, were fully vested upon issuance, were exercisable at the option of the holder, in whole or in part, and would have expired in March 2029. On March 22, 2019, the Company entered into a second amendment to the Amended Credit Agreement and Guaranty increasing the allowable permitted indebtedness in connection with the Company’s credit card program from $0.3 million to $0.5 million. On June 10, 2020, Perceptive exercised all of its outstanding warrants. See Note 10 “Warrants” for further details. On June 16, 2020, the Company entered into a third amendment to the Amended Credit Agreement and Guaranty (the “2020 Amended Credit Agreement and Guaranty”), which amended the prepayment premium by clarifying the methodology for calculating Perceptive’s annualized internal rate of return under the term loan. Pursuant to the 2020 Amended Credit Agreement and Guaranty, the outstanding principal amount accrues interest at an annual rate equal to 9.06% plus the greater of (a) one-month LIBOR and (b) 1.75% per year. At September 30, 2020, the interest rate was 10.81%. The outstanding balance, including accretion of the additional final payment due upon maturity and described below, was $42.6 million at September 30, 2020 and there was no remaining availability. The 2020 Amended Credit Agreement and Guaranty is secured by substantially all of the Company’s assets, including intellectual property. On the maturity date, in addition to the payment of principal and accrued interest, the Company will be required to make a payment of 0.5% of the total amount borrowed under the 2020 Amended Credit Agreement and Guaranty unless the Company has already made such a payment in connection with an acceleration or prepayment of borrowings under the agreement. In the event the Company prepays all or part of the amounts borrowed under the 2020 Amended Credit and Guaranty prior to the maturity date, the Company will be subject to additional prepayment fees which decrease as the time to maturity decreases. The 2020 Amended Credit Agreement and Guaranty requires the Company to comply with a minimum liquidity covenant at all times and a minimum revenue covenant measured at the end of each fiscal quarter. As of September 30, 2020, the Company was in compliance with all covenants. The annual principal maturities of the Company’s term loans as of September 30, 2020 are as follows: 2020 - 2021 - 2022 - 2023 42,603 Less: Discount on loans payable (603 ) Long-term loans payable $ 42,000 As discussed in Note 15 “Subsequent Events,” the Company fully repaid and terminated the 2020 Amended Credit Agreement and Guaranty on October 21, 2020.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2020
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	9. Commitments and Contingencies Legal From time to time, the Company may become involved in various legal proceedings, including those that may arise in the ordinary course of business. The Company believes there is no litigation pending that could have, individually, or in the aggregate, a material adverse effect on the results of its operations or financial condition.

Warrants

Warrants	9 Months Ended
	Sep. 30, 2020
Warrants And Rights Note Disclosure [Abstract]
Warrants	10. Warrants The Company’s warrant activity is summarized as follows: Common Stock Warrants Number of Shares Weighted Average Exercise Price Outstanding at December 31, 2019 182,076 $ 14.84 Warrants granted - - Warrants exercised (105,271 ) 15.46 Outstanding at September 30, 2020 76,805 $ 14.00 On June 10, 2020, a warrant to purchase 80,097 shares of common stock was exercised on a net exercise basis. Upon exercise, the exercise price of $15.92 per share was satisfied through the Company’s withholding of 39,031 of the warrant shares and issuing 41,066 shares of common stock. On July 10, 2020, a warrant to purchase 20,889 shares of common stock held was exercised on a net exercise basis. Upon exercise, the exercise price of $14.00 per share was satisfied through the Company’s withholding of 6,902 of the warrant shares and issuing 13,986 shares of common stock to the holder. On August 7, 2020, a warrant to purchase 4,285 shares of common stock held was exercised on a net exercise basis. Upon exercise, the exercise price of $14.00 per share was satisfied through the Company’s withholding of 2,064 of the warrant shares and issuing 2,222 shares of common stock to the holder. On October 1, 2020, a warrant to purchase 42,857 shares of common stock held was exercised on a net exercise basis. Upon exercise, the exercise price of $14.00 per share was satisfied through the Company’s withholding of 20,689 of the warrant shares and issuing 22,168 shares of common stock to the holder.

Revenue

Revenue	9 Months Ended
	Sep. 30, 2020
Revenue From Contract With Customer [Abstract]
Revenue	11. Revenue Disaggregated Revenue The following table shows the Company’s net revenue disaggregated into categories the Company considers meaningful: Three Months Ended September 30, Nine Months Ended September 30, 2020 2020 US International Total US International Total Net revenue by: Product Revenue Capital Equipment $ 13,198 $ 2,047 $ 15,245 $ 30,578 $ 8,970 $ 39,548 Disposable 10,426 2,618 13,044 29,561 9,076 38,637 Subtotal Product Revenue 23,624 4,665 28,289 60,139 18,046 78,185 Lease Revenue Capital Equipment 1,117 12 1,129 3,364 43 3,407 Other 442 82 524 1,194 233 1,427 Service and Other Revenue 343 274 617 852 955 1,807 Net Revenue $ 25,526 $ 5,033 $ 30,559 $ 65,549 $ 19,277 $ 84,826 Three Months Ended September 30, Nine Months Ended September 30, 2019 2019 US International Total US International Total Net revenue by: Product Revenue Capital Equipment $ 1,408 $ 647 $ 2,055 $ 4,517 $ 2,198 $ 6,715 Disposable 5,962 1,865 7,827 20,023 5,353 25,376 Subtotal Product Revenue 7,370 2,512 9,882 24,540 7,551 32,091 Lease Revenue 463 - 463 1,410 - 1,410 Service and Other Revenue 202 262 464 812 781 1,593 Net Revenue $ 8,035 $ 2,774 $ 10,809 $ 26,762 $ 8,332 $ 35,094 United States and International net revenue is based on the customer location to which the product is shipped. No individual foreign country represents more than 10% of the Company’s total revenue. Contract Balances from Contracts with Customers Contract liabilities consist of deferred revenue and other contract liabilities associated with rebates and fees payable to GPOs, IDNs and distributor partners. Deferred revenues are included in accrued expenses and other liabilities in the accompanying consolidated balance sheets. The following table presents changes in contract liabilities during the nine months ended September 30, 2020: Contract Liabilities Deferred Revenue Balance at December 31, 2019 $ 137 $ 344 Additions 279 912 Subtractions (137 ) (735 ) Balance at September 30, 2020 $ 279 $ 521

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2020
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock-Based Compensation	12. Stock-Based Compensation Stock-based compensation expense was allocated based on the employees’ and non-employees’ functions as follows: Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Cost of goods sold $ 86 $ 9 $ 231 $ 147 Research and development 204 11 604 266 Sales and marketing 592 (102 ) 1,512 657 General and administrative 874 299 2,233 1,871 Total $ 1,756 $ 217 $ 4,580 $ 2,941 Stock Options The Company granted options to purchase 964,568 shares of common stock at exercise prices ranging from $10.60 to $52.94 per share, with a weighted average exercise price of $13.07 per share, during the nine months ended September 30, 2020. The Company granted options to purchase 871,346 shares of common stock at exercise prices ranging from $13.35 to $19.40 per share, with a weighted average exercise price of $17.36 per share, during the nine months ended September 30, 2019. The weighted average fair value of stock options granted during the nine months ended September 30, 2020 and 2019 was $9.60 and $10.88, respectively. The weighted average assumptions used in the Black-Scholes options pricing model are as follows: Nine Months Ended September 30, 2020 2019 Expected dividend yield 0.0 % 0.0 % Risk free interest rate 1.7 % 2.1 % Expected stock price volatility 87.6 % 63.5 % Expected term (years) 6.1 6.2 Restricted Stock A summary of restricted stock activity for the nine months ended September 30, 2020 is as follows: Weighted Average Grant Date Shares Fair Value Unvested at December 31, 2019 229,913 $ 3.76 Granted 107,209 23.26 Vested (112,382 ) 4.64 Canceled (500 ) 10.97 Unvested at September 30, 2020 224,240 $ 10.50 Employee Stock Purchase Plan In connection with our initial public offering in November 2018, the Company’s board of directors adopted the ESPP and a total of 166,500 shares of common stock were initially reserved for issuance under the ESPP. The number of shares of common stock available for issuance under the ESPP is increased on the first day of each calendar year beginning January 1, 2019 and each year thereafter until 2028 by the lessor of (i) 1% of the number of shares of common stock issued and outstanding on the immediately preceding December 31, and (ii) the number of shares of common stock determined by the Company’s board of directors up to such an initial maximum of 1,741,300 shares of common stock. The number of shares of common stock reserved under the plan at September 30, 2020 totals 512,048. The ESPP provides for successive discrete offering periods of approximately six months or as determined by the plan administrator. The first offering period began on January 2, 2020. As of September 30, 2020, 36,389 shares of common stock were purchased by employees under the ESPP at a price of $9.88 per share, resulting in cash proceeds of $0.4 million. The ESPP permits eligible employees to elect to purchase shares of common stock through fixed whole percentage contributions from eligible compensation during each offering period, not to exceed 10% of the eligible compensation a participant receives during an offering period and not to accrue at a rate which exceeds $25,000 of the fair value of the stock (determined on the grant date(s)) for each calendar year. A participant may purchase the lower of (a) a number of shares of common stock determined by dividing such participant’s accumulated payroll deductions on the exercise date by the option price, (b) 5,000 shares, or (c) such other lesser maximum number of shares as shall have been established by the plan administrator. Amounts deducted and accumulated by the participant will be used to purchase shares of common stock at the end of each offering period. The purchase price of the shares will be 85% of the lower of the fair value of common stock on the first trading day of each offering period or on the purchase date. Participants may end their participation during an offering period up to ten days in advance of the exercise date and will be paid their accumulated contributions that have not been used to purchase shares of common stock. Participation ends automatically upon termination of employment. The fair value of the purchase right for the ESPP option is estimated on the date of grant using the Black-Scholes pricing model with the following assumptions during 2020: Expected dividend yield 0.0% Risk free interest rate 0.2% - 1.6% Expected stock price volatility 107.9% - 115.8% Expected term (years) 0.4 - 0.5

Net Loss Per Share

Net Loss Per Share	9 Months Ended
	Sep. 30, 2020
Earnings Per Share [Abstract]
Net Loss Per Share	13. Net Loss Per Share The Company excluded the following potential common shares, based on amounts outstanding at each period end, from the computation of diluted net loss per share attributable to common stockholders for the periods indicated because including them would have had an anti-dilutive effect: As of September 30, 2020 2019 Options to purchase common stock 1,770,880 1,407,448 Unvested restricted stock 224,240 267,566 Warrants to purchase common stock 76,805 182,076 Employee stock purchase plan shares 23,628 - 2,095,553 1,857,090

Related Party Transactions

Related Party Transactions	9 Months Ended
	Sep. 30, 2020
Related Party Transactions [Abstract]
Related Party Transactions	14. Related Party Transactions See Note 8 “Debt” for a discussion of the Company’s 2020 Amended Credit Agreement and Guaranty and related transactions with Perceptive, a holder of more than 5% of the Company’s common stock. 15. Subsequent Events On October 21, 2020 (the “Closing Date”), the Company entered into a loan and security agreement with Canadian Imperial Bank of Commerce Innovation Banking (“CIBC”) (the “Loan Agreement”). The Loan Agreement provides for a revolving loan facility of $12.0 million (the “Revolving Facility”) and a term loan facility of $40.0 million (the “Term Facility” and, together with the Revolving Facility, the “Facilities”). The proceeds of the Facilities were used to repay the Company’s existing revolving loan facility and term loan facility and for general corporate and working capital purposes. The Revolving Facility will mature on October 21, 2022 and may be renewed on an annual basis thereafter by mutual agreement of the Company and CIBC. The Term Facility will mature on October 21, 2025. Advances under the Facilities shall bear interest at a floating rate per annum equal to, (i) in the case of the Revolving Facility, the Wall Street Journal (“WSJ”) Prime Rate plus 1.0% and (ii) in the case of the Term Facility, the WSJ Prime Rate plus 2.5%. In each case, the WSJ Prime Rate is subject to a floor of 3.25%. The Loan Agreement provides for interest-only payments on the Term Facility for the first thirty-six months following the Closing Date. Thereafter, amortization payments on the Term Facility will be payable monthly in twenty-four equal installments. The Term Facility may not be prepaid prior to the first anniversary of the Closing Date without prepaying all of the interest that otherwise would have been payable on the Term Facility during the period commencing on the Closing Date and ending on the first anniversary of the Closing Date plus a prepayment charge of 2.0%. Thereafter, the Term Facility may be prepaid in full, subject to a prepayment charge of (i) 2.0%, if such prepayment occurs after the first anniversary of the Closing Date but on or prior to the second anniversary of the Closing Date, and (ii) 1.0%, if such prepayment occurs after the second anniversary of the Closing Date but on or prior to the third anniversary of the Closing Date. The Facilities are secured by a lien on substantially all of the assets of the Company, including intellectual property. The Loan Agreement contains customary covenants and representations, including, without limitation, a minimum revenue covenant equal to 80% of each year’s annual operating plan (tested on a trailing twelve month basis at the end of each fiscal quarter) and other financial covenants, reporting obligations, and limitations on dispositions, changes in business or ownership, mergers or acquisitions, indebtedness, encumbrances, distributions and investments, transactions with affiliates and capital expenditures. The events of default under the Loan Agreement include, without limitation, and subject to customary grace periods, (1) the Company’s failure to make any payments of principal or interest under the Loan Agreement or other loan documents, (2) the Company’s breach or default in the performance of any covenant under the Loan Agreement, (3) the occurrence of a material adverse effect or an event that is reasonably likely to result in a material adverse effect, (4) the existence of an attachment or levy on a material portion of funds of the Company or its subsidiaries, (5) the Company’s insolvency or bankruptcy, or (6) the occurrence of certain material defaults with respect to any other indebtedness of the Company in excess of $500,000. If an event of default occurs, CIBC is entitled to take enforcement action, including acceleration of amounts due under the Loan Agreement. The Loan Agreement also contains other customary provisions, such as expense reimbursement and confidentiality. CIBC has indemnification rights and the right to assign the Facilities, subject to customary restrictions. On October 21, 2020, the Company used approximately $40 million of the Term Facility, approximately $4.9 million of the Revolving Facility and approximately $5.7 million of cash on hand to pay off all obligations owing under, and to terminate, both the 2020 Amended Credit Agreement and Guaranty and the Third Amended Revolver Agreement, which included a prepayment penalty and exit fees of $3.7 million.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2020
Subsequent Events [Abstract]
Subsequent Events	15. Subsequent Events On October 21, 2020 (the “Closing Date”), the Company entered into a loan and security agreement with Canadian Imperial Bank of Commerce Innovation Banking (“CIBC”) (the “Loan Agreement”). The Loan Agreement provides for a revolving loan facility of $12.0 million (the “Revolving Facility”) and a term loan facility of $40.0 million (the “Term Facility” and, together with the Revolving Facility, the “Facilities”). The proceeds of the Facilities were used to repay the Company’s existing revolving loan facility and term loan facility and for general corporate and working capital purposes. The Revolving Facility will mature on October 21, 2022 and may be renewed on an annual basis thereafter by mutual agreement of the Company and CIBC. The Term Facility will mature on October 21, 2025. Advances under the Facilities shall bear interest at a floating rate per annum equal to, (i) in the case of the Revolving Facility, the Wall Street Journal (“WSJ”) Prime Rate plus 1.0% and (ii) in the case of the Term Facility, the WSJ Prime Rate plus 2.5%. In each case, the WSJ Prime Rate is subject to a floor of 3.25%. The Loan Agreement provides for interest-only payments on the Term Facility for the first thirty-six months following the Closing Date. Thereafter, amortization payments on the Term Facility will be payable monthly in twenty-four equal installments. The Term Facility may not be prepaid prior to the first anniversary of the Closing Date without prepaying all of the interest that otherwise would have been payable on the Term Facility during the period commencing on the Closing Date and ending on the first anniversary of the Closing Date plus a prepayment charge of 2.0%. Thereafter, the Term Facility may be prepaid in full, subject to a prepayment charge of (i) 2.0%, if such prepayment occurs after the first anniversary of the Closing Date but on or prior to the second anniversary of the Closing Date, and (ii) 1.0%, if such prepayment occurs after the second anniversary of the Closing Date but on or prior to the third anniversary of the Closing Date. The Facilities are secured by a lien on substantially all of the assets of the Company, including intellectual property. The Loan Agreement contains customary covenants and representations, including, without limitation, a minimum revenue covenant equal to 80% of each year’s annual operating plan (tested on a trailing twelve month basis at the end of each fiscal quarter) and other financial covenants, reporting obligations, and limitations on dispositions, changes in business or ownership, mergers or acquisitions, indebtedness, encumbrances, distributions and investments, transactions with affiliates and capital expenditures. The events of default under the Loan Agreement include, without limitation, and subject to customary grace periods, (1) the Company’s failure to make any payments of principal or interest under the Loan Agreement or other loan documents, (2) the Company’s breach or default in the performance of any covenant under the Loan Agreement, (3) the occurrence of a material adverse effect or an event that is reasonably likely to result in a material adverse effect, (4) the existence of an attachment or levy on a material portion of funds of the Company or its subsidiaries, (5) the Company’s insolvency or bankruptcy, or (6) the occurrence of certain material defaults with respect to any other indebtedness of the Company in excess of $500,000. If an event of default occurs, CIBC is entitled to take enforcement action, including acceleration of amounts due under the Loan Agreement. The Loan Agreement also contains other customary provisions, such as expense reimbursement and confidentiality. CIBC has indemnification rights and the right to assign the Facilities, subject to customary restrictions. On October 21, 2020, the Company used approximately $40 million of the Term Facility, approximately $4.9 million of the Revolving Facility and approximately $5.7 million of cash on hand to pay off all obligations owing under, and to terminate, both the 2020 Amended Credit Agreement and Guaranty and the Third Amended Revolver Agreement, which included a prepayment penalty and exit fees of $3.7 million.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”). The information included in this Quarterly Report on Form 10-Q should be read in conjunction with our audited consolidated financial statements and the accompanying notes included in our Annual Report on Form 10-K for the year ended December 31, 2019 (the “2019 Form 10-K”). Our accounting policies are described in the “ Notes to Consolidated Financial Statements ” in our 2019 Form 10-K and updated, as necessary, in this report. The year-end consolidated balance sheet data presented for comparative purposes was derived from our audited financial statements but does not include all disclosures required by U.S. GAAP.
Principles of Consolidation	Principles of Consolidation These condensed consolidated financial statements include the financial statements of Solus, a wholly owned subsidiary of the Company based in the United Kingdom, which was acquired in the first quarter of 2019. All intercompany accounts and transactions have been eliminated upon consolidation.
Segment Information	Segment Information Operating segments are defined as components of an enterprise for which separate discrete financial information is available and evaluated regularly by the chief operating decision maker in deciding how to allocate resources and in assessing performance. The Company globally manages the business within one reporting segment, Vapotherm, Inc. and two reporting units, Vapotherm and Solus. Segment information is consistent with how management reviews the business, makes investing and resource allocation decisions and assesses operating performance. The majority of the Company’s long-term assets are located in the United States. Long-term assets located outside the United States totaled $0.1 million as of each of September 30, 2020 and December 31, 2019.
Use of Estimates	Use of Estimates The preparation of condensed consolidated financial statements in conformity with U.S. GAAP requires the Company to make judgments, assumptions, and estimates that affect the reported amounts of assets, liabilities, revenue and expenses, and the related disclosure of contingent assets and liabilities. The Company evaluates its estimates on an ongoing basis. The Company bases its estimates on historical experience and various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Significant estimates relied upon in preparing these condensed consolidated financial statements include calculation of stock-based compensation, valuation of warrants, fair values of acquired assets and liabilities, including goodwill and intangibles assets, realizability of inventories, allowance for bad debts, accrued expenses and the valuation allowances against deferred income tax assets. Actual results may differ from these estimates.
Unaudited Interim Financial Information	Unaudited Interim Financial Information The accompanying condensed condensed condensed
Reclassification	Reclassification Certain amounts in 2019 have been reclassified to conform to the presentation in 2020. None of the reclassifications had any impact to the Company’s results of operations.
Concentrations of Credit Risk	Concentrations of Credit Risk As of September 30, 2020, the Company’s financial instruments were comprised of cash and cash equivalents, restricted cash, accounts receivable, accounts payable and debt, the carrying amounts of which approximated fair value due to their short-term nature and market interest rates. All of the Company’s cash and cash equivalents are maintained at creditworthy financial institutions. At September 30, 2020, deposits exceed the amount of any federal depositary insurance provided. The Company extends credit to customers in the normal course of business but typically does not require collateral or any other security to support amounts due. Management performs ongoing credit evaluations of the Company’s customers. An allowance for potentially uncollectible accounts is provided based on history, economic conditions, and composition of the accounts receivable aging. In some cases, the Company makes allowances for specific customers based on these and other factors. Provisions for the allowance for doubtful accounts are recorded in general and administrative expenses in the accompanying condensed consolidated statements of comprehensive loss.
Foreign Currency and Foreign Operations	Foreign Currency and Foreign Operations The functional currency of the Company is the currency of the primary economic environment in which the entity operates, which is the U.S. dollar. For our non-U.S. subsidiary that transacts in a functional currency other than the U.S. dollar, assets and liabilities are translated at current rates of exchange as of the balance sheet date. Income and expense items are translated at the average foreign currency exchange rates for the period. Adjustments resulting from the translation of the financial statements of its foreign operations into U.S. dollars are excluded from the determination of net loss and are recorded in accumulated other comprehensive income (loss), a separate component of stockholders’ equity. Realized foreign currency gains or losses arising from transactions denominated in foreign currencies are recorded in other (expense) income in the condensed consolidated statements of comprehensive loss.
Cash, Cash Equivalents, and Restricted Cash	Cash, Cash Equivalents, and Restricted Cash The Company considers all highly liquid temporary investments purchased with original maturities of 90 days or less to be cash equivalents. The Company holds restricted cash related to certificates of deposits and collateral in relation to lease agreements. As of September 30, 2020, $0.4 million of our $140.9 million of cash, cash equivalents and restricted cash balance was located outside the United States. The following table presents the components of total cash, cash equivalents, and restricted cash as set forth in the Company’s condensed consolidated statements of cash flows: September 30, 2020 December 31, 2019 Cash and cash equivalents $ 139,015 $ 71,655 Restricted cash 1,853 1,852 Total cash, cash equivalents, and restricted cash $ 140,868 $ 73,507
Product Warranty	Product Warranty The Company provides its customers with a standard one-year Balance at December 31, 2019 $ 225 Provisions for warranty obligations 659 Settlements (166 ) Balance at September 30, 2020 $ 718
Insurance	Insurance Effective January 1, 2020, the Company was self-insured for certain obligations related to health insurance. The Company also purchases stop-loss insurance to protect itself from material losses. Judgments and estimates are used in determining the potential value associated with reported claims and for events that have occurred but have not been reported. The Company’s estimates consider expected claim experience and other factors. Receivables for insurance recoveries are recorded as assets, on an undiscounted basis. The Company’s liabilities are based on estimates, and, while the Company believes that its accruals are adequate, the ultimate liability may be significantly different from the amounts recorded. Changes in claims experience, the Company’s ability to settle claims or other estimates and judgments used by management could have a material impact on the amount and timing of expense for any period.
Revenue Recognition	Revenue Recognition The Company’s revenue is primarily derived from the sale of products, leases and services. Product revenue consists of capital equipment and single-use disposables that are shipped and billed to customers both domestically and internationally. The Company’s main capital equipment products are the Precision Flow Hi-VNI, Precision Flow Plus, Precision Flow Classic, Vapotherm Transfer Unit 2.0 and Q50 compressor. The Company’s main disposable products are single-use disposables and nasal interfaces, or cannulas, and adaptors. Lease revenue consists of two components which include capital equipment that the Company leases out to its customers and, in certain situations, an allocation from disposable revenue to other lease revenue upon the sale of disposable products in bundled arrangements involving the placement of Precision Flow capital units for use by the customer at no upfront charge in connection with the customer’s ongoing purchase of disposable products. Service revenue consists of fees associated with routine service of capital units and the sale of extended service contracts and preventative maintenance plans, which are purchased by a small portion of the Company’s customer base. In addition, the Company sells small quantities of component parts in the United States, United Kingdom and to third-party international service centers who provide service on Precision Flow capital units outside of the United States and United Kingdom. Freight revenue is based upon actual freight costs plus a percentage markup of such costs associated with the shipment of products domestically, and to a lesser extent, internationally, and is included in service revenue. Rebates and fees consist of contractually obligated administrative fees and percentage-of-sales rebates paid to Group Purchasing Organizations (“GPOs”), Integrated Delivery Networks (“IDNs”) and distributor partners and accounted for as a reduction of service revenue. Under the Financial Accounting Standard Board’s (“FASB”) Accounting Standards Codification (“ASC”) 606, Revenue from Contracts with Customers (“ASC 606”), revenue is recognized when a customer obtains control of promised goods or services, in an amount that reflects the consideration which the Company expects to receive in exchange for those goods or services. To determine revenue recognition for arrangements that an entity determines are within the scope of ASC 606, the Company performs the following five steps: (i) identify the contract(s) with a customer; (ii) identify the performance obligations in the contract; (iii) determine the transaction price; (iv) allocate the transaction price to the performance obligations in the contract; and (v) recognize revenue when (or as) the entity satisfies a performance obligation. The Company only applies the five-step model to contracts when it is probable that the entity will collect the consideration it is entitled to in exchange for the goods or services it transfers to the customer. At contract inception, once the contract is determined to be within the scope of ASC 606, the Company assesses the goods or services promised within each contract and assesses whether each promised good or service is distinct and determines those that are performance obligations. The Company then recognizes as revenue the amount of the transaction price that is allocated to the respective performance obligation when (or as) the performance obligation is satisfied. Sales, value-added, and other taxes collected on behalf of third parties are excluded from revenue. The Company’s standard payment terms are generally 30 days from the date of sale. Contracts with customers may contain multiple performance obligations. For such arrangements, the transaction price is allocated to each performance obligation based on the estimated relative stand-alone selling prices of the promised products or services underlying each performance obligation. The Company determines stand-alone selling prices based on the price at which the performance obligation is sold separately. If the stand-alone selling price is not observable through past transactions, the Company estimates the stand-alone selling price taking into account available information such as market conditions and internally approved pricing guidelines related to the performance obligations. When determining the transaction price of a contract, an adjustment is made if payment from a customer occurs either significantly before or significantly after performance, resulting in a significant financing component. Applying the practical expedient in paragraph ASC 606-10-32-18, the Company does not assess whether a significant financing component exists if the period between when the Company performs its obligations under the contract and when the customer pays is one year or less. None of the Company’s contracts contained a significant financing component during the nine months ended September 30, 2020 or 2019. The Company’s contracts with its customers have a duration of less than one year. Therefore, the Company has elected to apply a practical expedient and recognizes the incremental costs of obtaining contracts as an expense. These costs are included in sales and marketing expense in the accompanying condensed consolidated statements of comprehensive loss.
Lease Revenue	Lease Revenue The Company also enters into agreements to lease its capital equipment. For such sales, the Company accounts for revenue under ASC 840, Leases, and assesses and classifies these transactions as sales-type or operating leases based on whether the lease transfers ownership of the equipment to the lessee by the end of the lease term. This criterion is met in situations in which the lease agreement provides for the transfer of title at or shortly after the end of the lease term. Equipment included in arrangements including transfer of title are accounted for as sales-type leases and the Company recognizes the total value of the lease payments due over the lease term to revenue at the inception of the lease. The Company records the current value of future lease payments under prepaid expenses and other current assets in the accompanying condensed consolidated balance sheets; these amounts totaled $1.7 and $0.9 million at September 30, 2020 and December 31, 2019, respectively. Equipment included in arrangements that do not include the transfer of title, nor any of the capital lease criteria, are accounted for as operating leases and revenue is recognized on a straight-line basis as it becomes receivable monthly over the term of the lease. The Company also enters into agreements involving the placement of Precision Flow capital units for use by the customer at no upfront charge in connection with the customer’s ongoing purchase of disposable products. In these bundled arrangements, revenue recognized for the sale of the disposables is allocated between disposable revenue and other lease revenue based on the estimated relative stand-alone selling prices of the individual performance obligations.
Shipping and Handling Costs	Shipping and Handling Costs Amounts billed to customers for shipping and handling are included in service revenue. Shipping and handling costs are included in costs of sales. The total costs of shipping and handling for the three months ended September 30, 2020 and 2019 was $0.6 and $0.2 million, respectively. Shipping and handling costs for the nine months ended September 30, 2020 and 2019 totaled $1.7 and $0.7 million, respectively.
Sales and Value-Added Taxes	Sales and Value-Added Taxes When required by local jurisdictions, the Company bills its customers for sales tax and value-added tax calculated on each sales invoice and records a liability for the sales and value-added tax payable, which is included in accrued expenses and other liabilities in the condensed consolidated balance sheets. Sales tax and value-added tax billed to a customer are not included in the Company’s revenue.
Timing and Amount of Revenue Recognition	Timing and Amount of Revenue Recognition The Company recognizes revenue on product sales and service of its capital equipment and product sales of disposables to its end users in the United States and United Kingdom and to its distribution partners in other international markets. In each instance, revenue is generally recognized when the customer obtains control of the Company’s product, which generally occurs at a point in time upon shipment based on the contractual shipping terms of a contract. Product and service revenue is measured as the amount of consideration the Company expects to receive in exchange for transferring products or services to a customer. To the extent the transaction price includes variable consideration, the Company estimates the amount of variable consideration that should be included in the transaction price utilizing the expected value amount method to which the Company expects to be entitled. As such, revenue on sales is recorded net of prompt pay discounts and payments made to GPOs, IDNs and distributors. Variable consideration is included in the transaction price if, in the Company’s judgment, it is probable that a significant future reversal of cumulative revenue under the contract will not occur. Determination of whether to include estimated amounts in the transaction price is based largely on an assessment of the Company’s anticipated performance and all information (historical, current and forecasted) that is reasonably available. The Company believes that the estimates it has established are reasonable based upon current facts and circumstances. Applying different judgments to the same facts and circumstances could result in different estimates.
Stock-Based Compensation	Stock-Based Compensation The Company maintains an equity incentive plan to provide long-term incentives for employees, consultants, and members of the board of directors. The plan allows for the issuance of non-statutory and incentive stock options, restricted stock, unrestricted stock, stock units, including restricted stock units, and stock appreciation rights to employees, consultants and non-employee directors. The Company recognizes stock-based compensation expense for awards of equity instruments to employees and non-employees based on the grant date fair value of those awards in accordance with ASC Topic 718, Stock Compensation (“ASC 718”). ASC 718 requires all equity-based compensation awards, including grants of restricted shares and stock options, to be recognized as expense in the condensed consolidated statements of comprehensive loss based on their grant date fair values. The fair value of each option grant is estimated on the grant date using the Black-Scholes option pricing model. The fair value is then amortized on a straight-line basis over the requisite service period of the awards, which is generally the vesting period. For performance-based awards, the related compensation cost is amortized over the performance period on an accelerated attribution basis. Compensation cost associated with performance awards is based on fair value on the date of grant and the number of units expected to be earned after assessing the probability that certain performance criteria will be met and the associated targeted payout level that is forecasted will be achieved. Cumulative adjustments are recorded each quarter to reflect estimated outcomes of the performance-related conditions until the results are determined and settled. Use of a valuation model requires management to make certain assumptions with respect to selected model inputs, including the expected life (weighted average period of time that the options granted are expected to be outstanding), the volatility of the Company’s common stock and an assumed risk-free interest rate. Expected volatility is calculated based on historical volatility of a group of publicly traded companies that the Company considers a peer group. The expected life is estimated using the simplified method for “plain vanilla” options. The risk-free interest rate is based on U.S. Treasury rates with a remaining term that approximates the expected life assumed at the date of grant. No dividend yield is assumed as the Company does not pay, and does not expect to pay, dividends on its common stock. The Company estimates forfeitures based on historical experience with pre-vested forfeitures. To the extent actual forfeitures differ from the estimate, the difference is recorded to compensation expense in the period of the forfeiture. The Company recognizes stock-based expense for shares issued pursuant to its 2018 Employee Stock Purchase Plan (“ESPP”) on a straight-line basis over the related offering period. The Company estimates the fair value of shares to be issued under the ESPP based on a combination of options valued using the Black-Scholes option pricing model. The expected life is determined based on the contractual term. D ividend yield and forfeiture rates are estimated in a manner similar to option grants described above and expected volatility is based on the Company’s historical volatility .
Income Tax	Income Tax The Company accounts for income taxes using the asset and liability method, which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been recognized in the condensed consolidated financial statements or in the Company’s tax returns. Deferred taxes are determined based on the difference between the financial reporting and tax basis of assets and liabilities using enacted tax rates in effect in the years in which the differences are expected to reverse. Changes in deferred tax assets and liabilities are recorded in the provision for income taxes. The Company assesses the likelihood that its deferred tax assets will be recovered from future taxable income and, to the extent it believes, based upon the weight of available evidence, that it is more likely than not that all or a portion of deferred tax assets will not be realized, a valuation allowance is established through a charge to income tax expense. Potential for recovery of deferred tax assets is evaluated by estimating the future taxable profits expected and considering prudent and feasible tax planning strategies. The Company accounts for uncertainty in income taxes recognized in the condensed consolidated financial statements by applying a two-step process to determine the amount of tax benefit to be recognized. First, the tax position must be evaluated to determine the likelihood that it will be sustained upon external examination by the taxing authorities. If the tax position is deemed more likely than not to be sustained, the tax position is then assessed to determine the amount of benefit to recognize in the condensed consolidated financial statements. The amount of the benefit that may be recognized is the largest amount that has a greater than 50% likelihood of being realized upon ultimate settlement. The provision for income taxes includes the effects of any resulting tax reserves, or unrecognized tax benefits, that are considered appropriate as well as the related net interest and penalties. The Company’s major tax jurisdictions are the United States, New Hampshire and the United Kingdom. There is no provision or benefit for income taxes for the three or nine months ended September 30, 2020 or 2019 because the Company has historically incurred operating losses and maintains a full valuation allowance against its United States net deferred tax assets. Utilization of the net operating loss and tax credit carryforwards may be subject to a substantial annual limitation under Sections 382 and 383 of the Internal Revenue Code of 1986, as amended (the “Code”) due to ownership change limitations that have occurred previously or that could occur in the future. These ownership changes may limit the amount of net operating loss and tax credit carryforwards that can be utilized to offset future taxable income and reduce taxes, respectively. The Company has not currently completed an evaluation of ownership changes through September 30, 2020 or December 31, 2019 to assess whether utilization of the Company’s net operating loss and tax credit carryforwards would be subject to an annual limitation under Sections 382 and 383 of the Code. To the extent an ownership change is determined to have occurred under Sections 382 and 383 of the Code, the net operating loss and tax credit carryforwards may be subject to limitation.
Recently Adopted Accounting Pronouncements	Recently Issued Accounting Pronouncements As an emerging growth company (“EGC”), the Jumpstart Our Business Startups Act (the “JOBS Act”) allows the Company to delay adoption of new or revised accounting pronouncements applicable to public companies until such pronouncements are made applicable to private companies. The Company has elected to use the adoption dates applicable to private companies. As a result, the Company’s consolidated financial statements may not be comparable to the financial statements of issuers who are required to comply with the effective date for new or revised accounting standards that are applicable to public companies. The Company expects it will no longer qualify as an EGC as of December 31, 2020 and, at that time, will begin to adopt certain accounting pronouncements at dates applicable to public companies. Leases (Topic 842): In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) (“ASU 2016-02”). ASU 2016-02 establishes a comprehensive new lease accounting model. The new standard clarifies the definitions of a lease, requires a dual approach to lease classification similar to current lease classifications, and causes lessees to recognize leases on the balance sheet as a lease liability with a corresponding right-of-use asset for leases with a lease term of more than twelve months. In July 2018, the FASB issued ASU No. 2018-11 Leases (Topic 842) (“ASU 2018-11”) which provided another transition method in addition to the existing transition method by allowing entities to initially apply the new leases standard at the adoption date. In June 2020, the FASB issued ASU 2020-05, Revenue from Contracts with Customers (Topic 606) and Leases (Topic 842), which defers the effective date for ASU 2016-02 to annual periods beginning after December 15, 2021 and interim periods beginning after December 15, 2022 for private companies or EGCs following private company adoption dates. The standard was effective for public companies for periods beginning after December 31, 2018. The new standard originally required a modified retrospective transition for capital or operating leases existing at or entered into after the beginning of the earliest comparative period presented in the financial statements, but it does not require transition accounting for leases that expire prior to the date of the initial application. The Company expects to adopt the new standard in the fourth quarter of 2020 with an effective date of January 1, 2020. The Company is in the process of adopting the new standard, including evaluating the changes that will be required under this standard to its future financial reporting and disclosures, and the Company has designed and implemented related processes and controls to address these changes. The Company expects the most significant effects of adoption to relate to (1) the recognition of new right-of-use assets and lease liabilities on the balance sheet for the Company’s facilities and certain other operating leases; and (2) the need to provide new disclosures about the Company’s leasing activities related to the amount, timing and uncertainty of cash flows arising from leases. Credit Losses (Topic 326): In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments (“ASU 2016-13”). This standard requires that credit losses be reported using an expected losses model rather than the incurred losses model that is currently used and establishes additional disclosures related to credit risks. In November 2019, the FASB issued ASU 2019-10, Financial Instruments-Credit Losses (Topic 326), Derivative and Hedging (Topic 815) and Leases (Topic 842), which defers the effective date for ASU 2016-13 to interim and annual periods beginning after December 15, 2022 for private companies, EGCs following private company adoption dates, or public entities meeting the definition of smaller reporting companies as of the date of issuance of this update. The Company has not yet determined the effects, if any, that the adoption of ASU 2016-13 may have on its financial position, results of operations, cash flows, or disclosures.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Components of Cash, Cash Equivalents and Restricted Cash	The following table presents the components of total cash, cash equivalents, and restricted cash as set forth in the Company’s condensed consolidated statements of cash flows: September 30, 2020 December 31, 2019 Cash and cash equivalents $ 139,015 $ 71,655 Restricted cash 1,853 1,852 Total cash, cash equivalents, and restricted cash $ 140,868 $ 73,507
Summary of Roll-Forward Warranty Liability	A roll-forward of the Company’s warranty liability from December 31, 2019 to September 30, 2020 is as follows: Balance at December 31, 2019 $ 225 Provisions for warranty obligations 659 Settlements (166 ) Balance at September 30, 2020 $ 718

Business Combinations (Tables)

Business Combinations (Tables)	9 Months Ended
	Sep. 30, 2020
Business Combinations [Abstract]
Summary of Purchase Price Allocation	The following table summarizes the purchase price allocation that includes the fair values of the separately identifiable assets acquired and liabilities assumed as of February 28, 2019: Cash $ 466 Accounts receivable 411 Inventory 492 Prepaids and other assets 3 Property and equipment 1 Goodwill 592 Intangible assets 455 Total assets acquired 2,420 Accounts payable and accrued expenses (241 ) Contract liabilities (75 ) Deferred taxes (78 ) Total liabilities assumed (394 ) Total purchase price $ 2,026
Summary of Business Acquisition Pro Forma Information	The following unaudited pro forma information for the three and nine months ended September 30, 2019 presents consolidated information as if the Solus acquisition occurred on January 1, 2019, which was the first day of the Company’s fiscal year 2019: Three Months Ended September 30, Nine Months Ended September 30, 2019 2019 Net revenue $ 10,809 $ 35,331 Net loss $ (12,765 ) $ (38,553 ) Net loss per share, basic $ (0.65 ) $ (2.16 )

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2020
Warrants
Schedule of Assumptions Used in Black-Scholes Options Pricing Model at the Date of Grant	The assumptions used in the Black-Scholes pricing model were as follows at the date of grant: Expected dividend yield 0.0 % Risk free interest rate 2.4 % Expected stock price volatility 60.9 % Expected term (years) 10.0

Accounts Receivable (Tables)

Accounts Receivable (Tables)	9 Months Ended
	Sep. 30, 2020
Receivables [Abstract]
Summary of Accounts Receivable	Accounts receivable by customer location consists of the following: September 30, 2020 December 31, 2019 United States $ 7,530 $ 5,574 International 3,883 2,908 Total accounts receivable 11,413 8,482 Less: Allowance for doubtful accounts (538 ) (239 ) Accounts receivable, net of allowance for doubtful accounts $ 10,875 $ 8,243

Inventories (Tables)

Inventories (Tables)	9 Months Ended
	Sep. 30, 2020
Inventory Disclosure [Abstract]
Schedule of Inventories	Inventories consist of the following: September 30, 2020 December 31, 2019 Component parts $ 10,918 $ 4,948 Finished goods 14,111 4,189 Total inventories $ 25,029 $ 9,137

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2020
Goodwill And Intangible Assets Disclosure [Abstract]
Schedule of Changes in Carrying Amount of Goodwill and Intangible Assets	The changes in the carrying amount of goodwill and intangible assets during 2020 are as follows: Goodwill Intangible Assets Balance at December 31, 2019 $ 588 $ 353 Acquired during the period - - Amortization - (85 ) Foreign currency exchange rate changes (17 ) (10 ) Balance at September 30, 2020 $ 571 $ 258
Summary of Previously Acquired Intangible Assets	The following table presents a summary of previously acquired intangible assets: As of September 30, 2020 Period of amortization Gross Carrying Amount Accumulated Amortization Customer agreements 3.83 $ 440 $ (182 ) Total identifiable intangible assets $ 440 $ (182 )

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2020
Debt Disclosure [Abstract]
Schedule of Annual Principal Maturities of Term Loans	The annual principal maturities of the Company’s term loans as of September 30, 2020 are as follows: 2020 - 2021 - 2022 - 2023 42,603 Less: Discount on loans payable (603 ) Long-term loans payable $ 42,000

Warrants (Tables)

Warrants (Tables)	9 Months Ended
	Sep. 30, 2020
Warrants And Rights Note Disclosure [Abstract]
Summary of Warrants Activity	The Company’s warrant activity is summarized as follows: Common Stock Warrants Number of Shares Weighted Average Exercise Price Outstanding at December 31, 2019 182,076 $ 14.84 Warrants granted - - Warrants exercised (105,271 ) 15.46 Outstanding at September 30, 2020 76,805 $ 14.00

Revenue (Tables)

Revenue (Tables)	9 Months Ended
	Sep. 30, 2020
Revenue From Contract With Customer [Abstract]
Net Revenue Disaggregated into Categories	The following table shows the Company’s net revenue disaggregated into categories the Company considers meaningful: Three Months Ended September 30, Nine Months Ended September 30, 2020 2020 US International Total US International Total Net revenue by: Product Revenue Capital Equipment $ 13,198 $ 2,047 $ 15,245 $ 30,578 $ 8,970 $ 39,548 Disposable 10,426 2,618 13,044 29,561 9,076 38,637 Subtotal Product Revenue 23,624 4,665 28,289 60,139 18,046 78,185 Lease Revenue Capital Equipment 1,117 12 1,129 3,364 43 3,407 Other 442 82 524 1,194 233 1,427 Service and Other Revenue 343 274 617 852 955 1,807 Net Revenue $ 25,526 $ 5,033 $ 30,559 $ 65,549 $ 19,277 $ 84,826 Three Months Ended September 30, Nine Months Ended September 30, 2019 2019 US International Total US International Total Net revenue by: Product Revenue Capital Equipment $ 1,408 $ 647 $ 2,055 $ 4,517 $ 2,198 $ 6,715 Disposable 5,962 1,865 7,827 20,023 5,353 25,376 Subtotal Product Revenue 7,370 2,512 9,882 24,540 7,551 32,091 Lease Revenue 463 - 463 1,410 - 1,410 Service and Other Revenue 202 262 464 812 781 1,593 Net Revenue $ 8,035 $ 2,774 $ 10,809 $ 26,762 $ 8,332 $ 35,094
Schedule of Changes in Contract Liabilities	The following table presents changes in contract liabilities during the nine months ended September 30, 2020: Contract Liabilities Deferred Revenue Balance at December 31, 2019 $ 137 $ 344 Additions 279 912 Subtractions (137 ) (735 ) Balance at September 30, 2020 $ 279 $ 521

Stock Plans and Stock-Based Com

Stock Plans and Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2020
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Summary of Allocated Stock Based Compensation Expense	Stock-based compensation expense was allocated based on the employees’ and non-employees’ functions as follows: Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Cost of goods sold $ 86 $ 9 $ 231 $ 147 Research and development 204 11 604 266 Sales and marketing 592 (102 ) 1,512 657 General and administrative 874 299 2,233 1,871 Total $ 1,756 $ 217 $ 4,580 $ 2,941
Schedule of Weighted Average Assumptions Used in Black-Scholes Options Pricing Model	The weighted average assumptions used in the Black-Scholes options pricing model are as follows: Nine Months Ended September 30, 2020 2019 Expected dividend yield 0.0 % 0.0 % Risk free interest rate 1.7 % 2.1 % Expected stock price volatility 87.6 % 63.5 % Expected term (years) 6.1 6.2
Summary of Restricted Stock Activity	A summary of restricted stock activity for the nine months ended September 30, 2020 is as follows: Weighted Average Grant Date Shares Fair Value Unvested at December 31, 2019 229,913 $ 3.76 Granted 107,209 23.26 Vested (112,382 ) 4.64 Canceled (500 ) 10.97 Unvested at September 30, 2020 224,240 $ 10.50
Schedule of Fair Value of ESPP Used in Black-Scholes Options Pricing Model	The fair value of the purchase right for the ESPP option is estimated on the date of grant using the Black-Scholes pricing model with the following assumptions during 2020: Expected dividend yield 0.0% Risk free interest rate 0.2% - 1.6% Expected stock price volatility 107.9% - 115.8% Expected term (years) 0.4 - 0.5

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	9 Months Ended
	Sep. 30, 2020
Earnings Per Share [Abstract]
Schedule of Computation of Diluted Net Loss Per Share Attributable to Common Stockholders	The Company excluded the following potential common shares, based on amounts outstanding at each period end, from the computation of diluted net loss per share attributable to common stockholders for the periods indicated because including them would have had an anti-dilutive effect: As of September 30, 2020 2019 Options to purchase common stock 1,770,880 1,407,448 Unvested restricted stock 224,240 267,566 Warrants to purchase common stock 76,805 182,076 Employee stock purchase plan shares 23,628 - 2,095,553 1,857,090

Description of Business - Addit

Description of Business - Additional Information (Details) $ / shares in Units, $ in Thousands	Dec. 20, 2019USD ($)	Nov. 16, 2018USD ($)$ / sharesshares	May 31, 2020USD ($)$ / sharesshares	Apr. 30, 2020USD ($)shares	Aug. 31, 2019USD ($)$ / sharesshares	Jun. 30, 2020shares	Sep. 30, 2019shares	Sep. 30, 2020USD ($)System	Sep. 30, 2019USD ($)
Organization Consolidation And Presentation Of Financial Statements [Line Items]
Entity founded year								1993
Entity reincorporated year								2013
Number of versions of precision flow systems | System								4
Proceeds from issuance of common stock								$ 94,155	$ 48,669
Common Stock
Organization Consolidation And Presentation Of Financial Statements [Line Items]
Number of shares issued | shares			3,852,500		3,570,750	3,852,500	3,570,750
Exercise of underwriters option to purchase shares | shares			502,500		465,750
Public offering price of common stock | $ / shares			$ 26		$ 14.50
Proceeds from initial offering net of underwriting discounts and offering costs			$ 93,800		$ 48,300
Underwriting discount			6,000		3,100
Offering expenses			$ 300		$ 400
Initial Public Offering | Common Stock
Organization Consolidation And Presentation Of Financial Statements [Line Items]
Number of shares issued | shares		4,600,000
Exercise of underwriters option to purchase shares | shares		600,000
Public offering price of common stock | $ / shares		$ 14
Proceeds from initial offering net of underwriting discounts and offering costs		$ 57,400
Underwriting discount		4,500
Offering expenses		$ 2,500
ATM Agreement
Organization Consolidation And Presentation Of Financial Statements [Line Items]
Number of shares issued | shares				511,648
Gross proceeds from issuance of common stock				$ 10,200
Proceeds from issuance of common stock				$ 9,800
ATM Agreement | Jefferies LLC
Organization Consolidation And Presentation Of Financial Statements [Line Items]
Gross proceeds from issuance of common stock	$ 50,000

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Additional Information (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2020USD ($)	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)Segment	Sep. 30, 2019USD ($)	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)
Summary Of Significant Accounting Policies [Line Items]
Number of reporting segment | Segment			1
Number of reporting units | Segment			2
Maturity period of highly liquid investments with original maturities			90 days
Cash, cash equivalents and restricted cash balance	$ 140,868,000	$ 85,374,000	$ 140,868,000	$ 85,374,000	$ 73,507,000	$ 60,022,000
Standard product warranty period			1 year
Standard payment term to customer			30 days
Revenue, performance obligation, description of payment terms			When determining the transaction price of a contract, an adjustment is made if payment from a customer occurs either significantly before or significantly after performance, resulting in a significant financing component. Applying the practical expedient in paragraph ASC 606-10-32-18, the Company does not assess whether a significant financing component exists if the period between when the Company performs its obligations under the contract and when the customer pays is one year or less.
Revenue, remaining performance obligation, amount	0	0	$ 0	$ 0
Dividend yield assumed			0.00%	0.00%
Provision or benefit for income taxes	0	0	$ 0	$ 0
Shipping and Handling
Summary Of Significant Accounting Policies [Line Items]
Shipping and handling costs	600,000	200,000	1,700,000	700,000
Prepaid Expenses and Other Current Assets
Summary Of Significant Accounting Policies [Line Items]
Current value of future lease payments		$ 1,700,000		$ 1,700,000	900,000
Outside U.S.
Summary Of Significant Accounting Policies [Line Items]
Long-term assets	100,000		100,000		$ 100,000
Cash, cash equivalents and restricted cash balance	$ 400,000		$ 400,000

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Components of Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019	Sep. 30, 2019	Dec. 31, 2018
Accounting Policies [Abstract]
Cash and cash equivalents	$ 139,015	$ 71,655
Restricted cash	1,853	1,852
Total cash, cash equivalents, and restricted cash	$ 140,868	$ 73,507	$ 85,374	$ 60,022

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Summary of Roll-Forward Warranty Liability (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2020USD ($)
Accounting Policies [Abstract]
Balance, beginning of period	$ 225
Provisions for warranty obligations	659
Settlements	(166)
Balance, end of period	$ 718

Business Combinations - Additio

Business Combinations - Additional Information (Details) - USD ($) $ in Thousands	Feb. 28, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2020	Dec. 31, 2019
Business Acquisition [Line Items]
Purchase price, net of cash acquired			$ 1,560
Solus
Business Acquisition [Line Items]
Acquisition date		Feb. 28, 2019
Purchase price, net of cash acquired	$ 2,000
Initial cash payment	1,600
Settlement of receivable from preexisting relationship	$ 400
Contingent consideration as compensation expense					$ 1,000
Weighted average amortization period for intangible assets		3 years 9 months 29 days
Solus | General and administrative
Business Acquisition [Line Items]
Transaction costs associated with acquisition					$ 200
Solus | Scenario Forecast
Business Acquisition [Line Items]
Contingent consideration as compensation to be recognized				$ 1,200

Business Combinations - Summary

Business Combinations - Summary of Purchase Price Allocation (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019	Feb. 28, 2019
Business Acquisition [Line Items]
Goodwill	$ 571	$ 588
Solus
Business Acquisition [Line Items]
Cash			$ 466
Accounts receivable			411
Inventory			492
Prepaids and other assets			3
Property and equipment			1
Goodwill			592
Intangible assets			455
Total assets acquired			2,420
Accounts payable and accrued expenses			(241)
Contract liabilities			(75)
Deferred taxes			(78)
Total liabilities assumed			(394)
Total purchase price			$ 2,026

Business Combinations - Summa_2

Business Combinations - Summary of Business Acquisition Pro Forma Information (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2019
Business Combinations [Abstract]
Net revenue	$ 10,809	$ 35,331
Net loss	$ (12,765)	$ (38,553)
Net loss per share, basic	$ (0.65)	$ (2.16)

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Details) - USD ($) $ in Millions	Sep. 30, 2020	Mar. 22, 2019
Amendment To Financing Arrangement | Common Stock Warrants
Class Of Warrant Or Right [Line Items]
Granted warrants to purchase shares		19,789
Level 1 | Money Market Deposits
Class Of Warrant Or Right [Line Items]
Cash equivalents	$ 123.2

Fair Value Measurements - Sched

Fair Value Measurements - Schedule of Assumptions Used in Black-Scholes Options Pricing Model at the Date of Grant (Details)	Sep. 30, 2020
Class Of Warrant Or Right [Line Items]
Expected term (years)	10 years
Expected Dividend Yield
Class Of Warrant Or Right [Line Items]
Key inputs used in valuation	0
Risk Free Interest Rate
Class Of Warrant Or Right [Line Items]
Key inputs used in valuation	0.024
Expected Stock Price Volatility
Class Of Warrant Or Right [Line Items]
Key inputs used in valuation	0.609

Accounts Receivable - Summary o

Accounts Receivable - Summary of Accounts Receivable (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Accounts Notes And Loans Receivable [Line Items]
Total accounts receivable	$ 11,413	$ 8,482
Less: Allowance for doubtful accounts	(538)	(239)
Accounts receivable, net of allowance for doubtful accounts	10,875	8,243
United States
Accounts Notes And Loans Receivable [Line Items]
Total accounts receivable	7,530	5,574
International
Accounts Notes And Loans Receivable [Line Items]
Total accounts receivable	$ 3,883	$ 2,908

Accounts Receivable - Additiona

Accounts Receivable - Additional Information (Details) - Customer Concentration Risk - Customer	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Revenue
Accounts Notes And Loans Receivable [Line Items]
Number of customer accounted more than 10%	0	0	0	0
Percentage of concentration risk	10.00%	10.00%	10.00%	10.00%
Accounts Receivable
Accounts Notes And Loans Receivable [Line Items]
Number of customer accounted more than 10%			0		0
Percentage of concentration risk			10.00%		10.00%

Inventories - Schedule of Inven

Inventories - Schedule of Inventories (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Inventory Disclosure [Abstract]
Component parts	$ 10,918	$ 4,948
Finished goods	14,111	4,189
Total inventories	$ 25,029	$ 9,137

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Schedule of Changes in Carrying Amount of Goodwill and Intangible Assets (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2020USD ($)
Goodwill
Balance at December 31, 2019	$ 588
Foreign currency exchange rate changes	(17)
Balance at September 30, 2020	571
Intangible Assets
Balance at December 31, 2019	353
Amortization	(85)
Foreign currency exchange rate changes	(10)
Balance at September 30, 2020	$ 258

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Summary of Previously Acquired Intangible Assets (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2020USD ($)
Acquired Finite Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 440
Accumulated Amortization	$ (182)
Customer Agreements
Acquired Finite Lived Intangible Assets [Line Items]
Period of amortization	3 years 9 months 29 days
Gross Carrying Amount	$ 440
Accumulated Amortization	$ (182)

Debt - Additional Information (

Debt - Additional Information (Details)

Sep. 29, 2020

Jun. 16, 2020

Mar. 22, 2019USD ($)$ / sharesshares

Sep. 27, 2018USD ($)$ / sharesshares

Jul. 20, 2018USD ($)$ / sharesshares

Apr. 06, 2018USD ($)Tranche$ / sharesshares

Nov. 16, 2016USD ($)

Apr. 30, 2018USD ($)

Sep. 30, 2020USD ($)

Sep. 30, 2019USD ($)

Dec. 31, 2019USD ($)

Mar. 21, 2019USD ($)

Debt Instrument [Line Items]

Proceeds from term loan

$ 10,500,000

Western Alliance Bank | Revolving Credit Line | Revolver Agreement

Debt Instrument [Line Items]

Line of credit made available under agreement

$ 7,000,000

$ 7,500,000

Percentage of eligible receivables used as base to calculate line of credit availability

80.00%

Line of credit, maturity date

Sep. 30, 2018

Sep. 30, 2020

Western Alliance Bank | Revolving Credit Line | Revolver Agreement | Credit Card Program

Debt Instrument [Line Items]

Line of credit made available under agreement

$ 300,000

Western Alliance Bank | Revolving Credit Line | First Amended Revolver Agreement

Debt Instrument [Line Items]

Line of credit, maturity date

Feb. 28, 2023

Western Alliance Bank | Revolving Credit Line | First Amended Revolver Agreement | Prime Rate

Debt Instrument [Line Items]

Line of credit, interest rate

3.25%

Western Alliance Bank | Revolving Credit Line | First Amended Revolver Agreement | Credit Card Program

Debt Instrument [Line Items]

Line of credit made available under agreement

$ 500,000

Western Alliance Bank | Revolving Credit Line | Third Amended Revolver Agreement

Debt Instrument [Line Items]

Line of credit, interest rate

3.25%

6.50%

Outstanding balance under line of credit

$ 4,500,000

$ 3,500,000

Line of credit, remaining availability under agreement

800,000

$ 800,000

Perceptive Credit Holdings II, LP | Credit Agreement and Guaranty | Term Loan

Debt Instrument [Line Items]

Term loan, face amount

$ 42,500,000

Number of tranches available under agreement | Tranche

3

Proceeds from term loan

$ 10,500,000

Granted warrants to purchase shares | shares

19,789

37,693

Warrants exercise price | $ / shares

$ 15.92

$ 15.92

Warrants expiration, month and year

2029-03

2028-04

Perceptive Credit Holdings II, LP | Credit Agreement and Guaranty | First Tranche | Term Loan

Debt Instrument [Line Items]

Proceeds from term loan

$ 20,000,000

Perceptive Credit Holdings II, LP | Credit Agreement and Guaranty | Debt Instrument Second Tranche | Term Loan

Debt Instrument [Line Items]

Proceeds from term loan

$ 10,000,000

Granted warrants to purchase shares | shares

18,846

Warrants exercise price | $ / shares

$ 15.92

Warrants expiration, month and year

2028-07

Perceptive Credit Holdings II, LP | First Amendment to Credit Agreement and Guaranty | Term Loan

Debt Instrument [Line Items]

Term loan available to be drawn

$ 12,500,000

Minimum revenue requirement to draw final tranche

43,200,000

Perceptive Credit Holdings II, LP | First Amendment to Credit Agreement and Guaranty | Credit Card Program | Term Loan

Debt Instrument [Line Items]

Line of credit made available under agreement

$ 300,000

Perceptive Credit Holdings II, LP | First Amendment to Credit Agreement and Guaranty | Debt Instrument Third Tranche | Term Loan

Debt Instrument [Line Items]

Proceeds from term loan

$ 2,000,000

Granted warrants to purchase shares | shares

3,769

Warrants exercise price | $ / shares

$ 15.92

Warrants expiration, month and year

2028-09

Perceptive Credit Holdings II, LP | Second Amendment to Credit Agreement and Guaranty | Credit Card Program | Term Loan

Debt Instrument [Line Items]

Line of credit made available under agreement

$ 500,000

Perceptive Credit Holdings II, LP | 2020 Amended Credit Agreement and Guaranty | Term Loan

Debt Instrument [Line Items]

Term loan, face amount

$ 42,600,000

Term loan, interest rate

9.06%

10.81%

Debt instrument rate

1.75%

Debt instrument, description

one-month LIBOR

Term loan, remaining availability under agreement

$ 0

Line of credit, covenant compliance description

The 2020 Amended Credit Agreement and Guaranty requires the Company to comply with a minimum liquidity covenant at all times and a minimum revenue covenant measured at the end of each fiscal quarter. As of September 30, 2020, the Company was in compliance with all covenants.

Line of credit facility percentage of amount borrowed

0.50%

Debt - Schedule of Annual Princ

Debt - Schedule of Annual Principal Maturities of Term Loans (Details) - Loans Payable $ in Thousands	Sep. 30, 2020USD ($)
Debt Instrument [Line Items]
2020	$ 0
2021	0
2022	0
2023	42,603
Less: Discount on loans payable	(603)
Long-term loans payable	$ 42,000

Warrants - Summary of Warrants

Warrants - Summary of Warrants Activity (Details) - Common Stock Warrants - $ / shares	Aug. 07, 2020	Jul. 10, 2020	Jun. 10, 2020	Sep. 30, 2020
Class Of Warrant Or Right [Line Items]
Number of shares, beginning balance				182,076
Number of shares, warrants exercised	(4,285)	(20,889)	(80,097)	(105,271)
Number of shares, ending balance				76,805
Weighted average exercise price, ending balance	$ 14	$ 14	$ 15.92
Weighted Average
Class Of Warrant Or Right [Line Items]
Weighted average exercise price, beginning balance				$ 14.84
Weighted average exercise price, warrants exercised				15.46
Weighted average exercise price, ending balance				$ 14

Warrants - Additional Informati

Warrants - Additional Information (Details) - Common Stock Warrants - $ / shares	Oct. 01, 2020	Aug. 07, 2020	Jul. 10, 2020	Jun. 10, 2020	Sep. 30, 2020
Class Of Warrant Or Right [Line Items]
Warrants to purchase of common stock shares, net exercised		4,285	20,889	80,097	105,271
Warrants exercise price		$ 14	$ 14	$ 15.92
Number of warrants withhold upon warrants exercise		2,064	6,902	39,031
Issuance of common stock upon exercise of warrants, shares		2,222	13,986	41,066
Subsequent Event
Class Of Warrant Or Right [Line Items]
Warrants to purchase of common stock shares, net exercised	42,857
Warrants exercise price	$ 14
Number of warrants withhold upon warrants exercise	20,689
Issuance of common stock upon exercise of warrants, shares	22,168

Revenue - Net Revenue Disaggreg

Revenue - Net Revenue Disaggregated into Categories (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 30,559	$ 10,809	$ 84,826	$ 35,094
US
Disaggregation Of Revenue [Line Items]
Net Revenue	25,526	8,035	65,549	26,762
International
Disaggregation Of Revenue [Line Items]
Net Revenue	5,033	2,774	19,277	8,332
Product Revenue, Capital Equipment
Disaggregation Of Revenue [Line Items]
Net Revenue	15,245	2,055	39,548	6,715
Product Revenue, Capital Equipment | US
Disaggregation Of Revenue [Line Items]
Net Revenue	13,198	1,408	30,578	4,517
Product Revenue, Capital Equipment | International
Disaggregation Of Revenue [Line Items]
Net Revenue	2,047	647	8,970	2,198
Product Revenue, Disposable
Disaggregation Of Revenue [Line Items]
Net Revenue	13,044	7,827	38,637	25,376
Product Revenue, Disposable | US
Disaggregation Of Revenue [Line Items]
Net Revenue	10,426	5,962	29,561	20,023
Product Revenue, Disposable | International
Disaggregation Of Revenue [Line Items]
Net Revenue	2,618	1,865	9,076	5,353
Subtotal Product Revenue
Disaggregation Of Revenue [Line Items]
Net Revenue	28,289	9,882	78,185	32,091
Subtotal Product Revenue | US
Disaggregation Of Revenue [Line Items]
Net Revenue	23,624	7,370	60,139	24,540
Subtotal Product Revenue | International
Disaggregation Of Revenue [Line Items]
Net Revenue	4,665	2,512	18,046	7,551
Lease Revenue, Capital Equipment
Disaggregation Of Revenue [Line Items]
Net Revenue	1,129		3,407
Lease Revenue, Capital Equipment | US
Disaggregation Of Revenue [Line Items]
Net Revenue	1,117		3,364
Lease Revenue, Capital Equipment | International
Disaggregation Of Revenue [Line Items]
Net Revenue	12		43
Lease Revenue, Other
Disaggregation Of Revenue [Line Items]
Net Revenue	524		1,427
Lease Revenue, Other | US
Disaggregation Of Revenue [Line Items]
Net Revenue	442		1,194
Lease Revenue, Other | International
Disaggregation Of Revenue [Line Items]
Net Revenue	82		233
Service and Other Revenue
Disaggregation Of Revenue [Line Items]
Net Revenue	617	464	1,807	1,593
Service and Other Revenue | US
Disaggregation Of Revenue [Line Items]
Net Revenue	343	202	852	812
Service and Other Revenue | International
Disaggregation Of Revenue [Line Items]
Net Revenue	$ 274	262	$ 955	781
Lease Revenue
Disaggregation Of Revenue [Line Items]
Net Revenue		463		1,410
Lease Revenue | US
Disaggregation Of Revenue [Line Items]
Net Revenue		$ 463		$ 1,410

Revenue - Schedule of Changes i

Revenue - Schedule of Changes in Contract Liabilities (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2020USD ($)
Contract Liabilities
Balance at December 31, 2019	$ 137
Additions	279
Subtractions	(137)
Balance at September 30, 2020	279
Deferred Revenue
Balance at December 31, 2019	344
Additions	912
Subtractions	(735)
Balance at September 30, 2020	$ 521

Stock-Based Compensation - Summ

Stock-Based Compensation - Summary of Allocated Stock Based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Allocated stock based compensation expense (income)	$ 1,756	$ 217	$ 4,580	$ 2,941
Cost of goods sold
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Allocated stock based compensation expense (income)	86	9	231	147
Research and development
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Allocated stock based compensation expense (income)	204	11	604	266
Sales and marketing
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Allocated stock based compensation expense (income)	592	(102)	1,512	657
General and administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Allocated stock based compensation expense (income)	$ 874	$ 299	$ 2,233	$ 1,871

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Details) - USD ($)	1 Months Ended	3 Months Ended	9 Months Ended
	Nov. 30, 2018	Jun. 30, 2020	Sep. 30, 2020	Sep. 30, 2019	May 31, 2020	Aug. 31, 2019
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options, granted			964,568	871,346
Exercise price range, lower range limit			$ 10.60	$ 13.35
Exercise price range, upper range limit			52.94	19.40
Weighted average exercise price			13.07	17.36
Weighted average fair value of stock options granted			$ 9.60	$ 10.88
Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock shares issued		36,389	36,389
Common stock price per share					$ 26	$ 14.50
Employee Stock Purchase Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock reserved for issuance	166,500		512,048
Common stock reserved and available for future issuance maximum cumulative increase percentage on immediate preceding year end common stock issued and outstanding	1.00%
Common stock reserved and available for issuance cumulatively increase description			The number of shares of common stock available for issuance under the ESPP is increased on the first day of each calendar year beginning January 1, 2019 and each year thereafter until 2028 by the lessor of (i) 1% of the number of shares of common stock issued and outstanding on the immediately preceding December 31, and (ii) the number of shares of common stock determined by the Company’s board of directors up to such an initial maximum of 1,741,300 shares of common stock. The number of shares of common stock reserved under the plan at September 30, 2020 totals 512,048.
Initial maximum number of common stock determined by board of directors	1,741,300
Cash proceeds from issuance of common stock			$ 360,000
Maximum percentage to purchase shares of eligible compensation a participant receives during each offering period	10.00%
Maximum amount of shares a participant can accrue at discounted rate of the fair market value.	$ 25,000
Maximum number of shares per participant	5,000
Purchase price as a percentage of its market price on first trading day of each offering period	85.00%
Employee Stock Purchase Plan | Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock price per share			$ 9.88

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Weighted Average Assumptions Used in Black-Scholes Options Pricing Model (Details)	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Expected dividend yield	0.00%	0.00%
Risk free interest rate	1.70%	2.10%
Expected stock price volatility	87.60%	63.50%
Expected term (years)	6 years 1 month 6 days	6 years 2 months 12 days

Stock-Based Compensation - Su_2

Stock-Based Compensation - Summary of Restricted Stock Activity (Details) - Restricted Stock	9 Months Ended
	Sep. 30, 2020$ / sharesshares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares, Unvested, Beginning balance | shares	229,913
Shares, Granted | shares	107,209
Shares, Vested | shares	(112,382)
Shares, Canceled | shares	(500)
Shares, Unvested Ending balance | shares	224,240
Weighted Average Grant Date Fair Value, Unvested, Beginning balance | $ / shares	$ 3.76
Weighted Average Grant Date Fair Value, Granted | $ / shares	23.26
Weighted Average Grant Date Fair Value, Vested | $ / shares	4.64
Weighted Average Grant Date Fair Value, Canceled | $ / shares	10.97
Weighted Average Grant Date Fair Value, Unvested Ending balance | $ / shares	$ 10.50

Stock-Based Compensation - Sc_2

Stock-Based Compensation - Schedule of Fair Value of ESPP Used in Black-Scholes Options Pricing Model (Details)	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected dividend yield	0.00%	0.00%
Expected term (years)	6 years 1 month 6 days	6 years 2 months 12 days
Employee Stock Purchase Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected dividend yield	0.00%
Risk free interest rate, minimum	0.20%
Risk free interest rate, maximum	1.60%
Expected stock price volatility, minimum	107.90%
Expected stock price volatility, maximum	115.80%
Employee Stock Purchase Plan | Minimum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected term (years)	4 months 24 days
Employee Stock Purchase Plan | Maximum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected term (years)	6 months

Net Loss Per Share - Schedule o

Net Loss Per Share - Schedule of Computation of Diluted Net Loss Per Share Attributable to Common Stockholders (Details) - shares	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	2,095,553	1,857,090
Employee Stock Purchase Plan Shares
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	23,628
Options to Purchase Common Stock
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	1,770,880	1,407,448
Warrants to Purchase Common Stock
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	76,805	182,076
Unvested Restricted Stock
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	224,240	267,566

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Details)	9 Months Ended
	Sep. 30, 2020
Minimum [Member]
Related Party Transaction [Line Items]
Percentage of common stock held by holder	5.00%

Subsequent Events - Additional

Subsequent Events - Additional Information (Details) - USD ($) $ in Thousands	Oct. 21, 2020	Sep. 30, 2020
Canadian Imperial Bank of Commerce Innovation Banking
Subsequent Event [Line Items]
Line of credit facility, description		The Term Facility may not be prepaid prior to the first anniversary of the Closing Date without prepaying all of the interest that otherwise would have been payable on the Term Facility during the period commencing on the Closing Date and ending on the first anniversary of the Closing Date plus a prepayment charge of 2.0%. Thereafter, the Term Facility may be prepaid in full, subject to a prepayment charge of (i) 2.0%, if such prepayment occurs after the first anniversary of the Closing Date but on or prior to the second anniversary of the Closing Date, and (ii) 1.0%, if such prepayment occurs after the second anniversary of the Closing Date but on or prior to the third anniversary of the Closing Date.
Loan agreement, payment terms		The Loan Agreement provides for interest-only payments on the Term Facility for the first thirty-six months following the Closing Date. Thereafter, amortization payments on the Term Facility will be payable monthly in twenty-four equal installments.
Debt instrument, covenant description		The events of default under the Loan Agreement include, without limitation, and subject to customary grace periods, (1) the Company’s failure to make any payments of principal or interest under the Loan Agreement or other loan documents, (2) the Company’s breach or default in the performance of any covenant under the Loan Agreement, (3) the occurrence of a material adverse effect or an event that is reasonably likely to result in a material adverse effect, (4) the existence of an attachment or levy on a material portion of funds of the Company or its subsidiaries, (5) the Company’s insolvency or bankruptcy, or (6) the occurrence of certain material defaults with respect to any other indebtedness of the Company in excess of $500,000. If an event of default occurs, CIBC is entitled to take enforcement action, including acceleration of amounts due under the Loan Agreement.
Subsequent Event
Subsequent Event [Line Items]
Prepayment penalty and exit fees	$ 3,700
Subsequent Event | Cash
Subsequent Event [Line Items]
Amount to pay off all obligations owing and termination of agreements	$ 5,700
Subsequent Event | Canadian Imperial Bank of Commerce Innovation Banking
Subsequent Event [Line Items]
Percentage of prepayment charge after first anniversary of closing date	2.00%
Percentage of prepayment charge after second anniversary of closing date	1.00%
Percentage of revenue covenant	80.00%
Minimum amount of other indebtedness	$ 500,000
Revolving Credit Line | Subsequent Event
Subsequent Event [Line Items]
Amount to pay off all obligations owing and termination of agreements	4,900
Revolving Credit Line | Subsequent Event | Canadian Imperial Bank of Commerce Innovation Banking
Subsequent Event [Line Items]
Outstanding balance under line of credit	$ 12,000
Debt instrument, maturity date	Oct. 21, 2022
Debt instrument rate	1.00%
Revolving Credit Line | Subsequent Event | Canadian Imperial Bank of Commerce Innovation Banking | Prime Rate
Subsequent Event [Line Items]
Line of credit, interest rate	3.25%
Term Facility | Subsequent Event
Subsequent Event [Line Items]
Amount to pay off all obligations owing and termination of agreements	$ 40,000
Term Facility | Subsequent Event | Canadian Imperial Bank of Commerce Innovation Banking
Subsequent Event [Line Items]
Outstanding balance under line of credit	$ 40,000
Debt instrument, maturity date	Oct. 21, 2025
Debt instrument rate	2.50%