NxStage Medical 10-Q 7 Nov 13 2013 Q3 Quarterly report Financial data

Document_and_Entity_Informatio

Document and Entity Information	9 Months Ended
	Sep. 30, 2013	Nov. 01, 2013
Document And Entity Information [Abstract]	'	'
Document Type	'10-Q	'
Amendment Flag	'false	'
Document Period End Date	30-Sep-13	'
Document Fiscal Year Focus	'2013	'
Document Fiscal Period Focus	'Q3	'
Entity Registrant Name	'NxStage Medical, Inc.	'
Entity Central Index Key	'0001333170	'
Current Fiscal Year End Date	'--12-31	'
Entity Filer Category	'Large Accelerated Filer	'
Entity Common Stock, Shares Outstanding	'	60,930,965

Condensed_Consolidated_Balance

Condensed Consolidated Balance Sheets (USD $)	Sep. 30, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Current assets:	'	'
Cash and cash equivalents	$83,159	$106,439
Accounts receivable, net	22,523	18,990
Inventory	37,097	33,504
Prepaid expenses and other current assets	5,024	2,534
Total current assets	147,803	161,467
Property and equipment, net	47,106	36,320
Field equipment, net	13,670	10,101
Deferred cost of revenues	33,692	38,028
Intangible assets, net	17,894	19,819
Goodwill	42,329	42,421
Other assets	2,108	3,793
Total assets	304,602	311,949
Current liabilities:	'	'
Accounts payable	16,798	16,645
Accrued expenses	18,160	20,400
Other current liabilities	2,516	2,187
Total current liabilities	37,474	39,232
Deferred revenues	52,361	59,262
Other long-term liabilities	19,676	15,864
Total liabilities	109,511	114,358
Commitments and contingencies (Note 10)	'	'
Stockholders' equity:	'	'
Undesignated preferred stock: par value $0.001, 5,000,000 shares authorized; no shares issued and outstanding as of September 30, 2013 and December 31, 2012	'	'
Common stock: par value $0.001, 100,000,000 shares authorized; 61,333,363 and 59,850,117 shares issued as of September 30, 2013 and December 31, 2012, respectively	61	59
Additional paid-in capital	563,191	551,594
Accumulated deficit	-358,366	-344,981
Accumulated other comprehensive income	168	470
Treasury stock, at cost: 575,895 and 541,584 shares as of September 30, 2013 and December 31, 2012, respectively	-9,963	-9,551
Total stockholders' equity	195,091	197,591
Total liabilities and stockholders' equity	$304,602	$311,949

Condensed_Consolidated_Balance1

Condensed Consolidated Balance Sheets (Parenthetical) (USD $)	Sep. 30, 2013	Dec. 31, 2012
Statement Of Financial Position [Abstract]	'	'
Undesignated preferred stock, par value	$0.00	$0.00
Undesignated preferred stock, shares authorized	5,000,000	5,000,000
Undesignated preferred stock, shares issued	'	'
Undesignated preferred stock, shares outstanding	'	'
Common stock, par value	$0.00	$0.00
Common stock, shares authorized	100,000,000	100,000,000
Common stock, shares issued	61,333,363	59,850,117
Treasury stock, shares	575,895	541,584

Condensed_Consolidated_Stateme

Condensed Consolidated Statements of Comprehensive Loss (USD $)	3 Months Ended		9 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Statement Of Income And Comprehensive Income [Abstract]	'	'	'	'
Revenues	$66,873	$61,152	$193,979	$177,112
Cost of revenues	41,345	37,404	119,364	109,663
Gross profit	25,528	23,748	74,615	67,449
Operating expenses:	'	'	'	'
Selling and marketing	12,374	10,168	34,786	30,006
Research and development	4,450	4,274	13,924	12,421
Distribution	5,326	4,731	15,271	13,845
General and administrative	7,791	6,921	23,854	20,473
Total operating expenses	29,941	26,094	87,835	76,745
Loss from operations	-4,413	-2,346	-13,220	-9,296
Other expense:	'	'	'	'
Interest expense	-162	-26	-462	-2,675
Other (expense) income, net	-142	13	-328	-118
Total other expense	-304	-13	-790	-2,793
Net loss before income taxes	-4,717	-2,359	-14,010	-12,089
Provision for (benefit from) income taxes	269	223	-625	700
Net loss	-4,986	-2,582	-13,385	-12,789
Net loss per share, basic and diluted	($0.08)	($0.04)	($0.22)	($0.22)
Weighted-average shares outstanding, basic and diluted	60,675	58,945	60,029	57,482
Other comprehensive income (loss)	257	711	-302	587
Total comprehensive loss	($4,729)	($1,871)	($13,687)	($12,202)

Condensed_Consolidated_Stateme1

Condensed Consolidated Statements of Cash Flows (USD $)	9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012
Cash flows from operating activities:	'	'
Net loss	($13,385)	($12,789)
Adjustments to reconcile net loss to net cash (used in) provided by operating activities:	'	'
Depreciation and amortization	18,430	17,495
Stock-based compensation	7,830	9,213
Other	2,251	3,047
Changes in operating assets and liabilities:	'	'
Accounts receivable	-3,473	-3,753
Inventory	-14,498	-11,638
Prepaid expenses and other assets	-2,549	-384
Accounts payable	49	-863
Accrued expenses and other liabilities	-3,847	3,691
Deferred revenues	-5,707	-3,449
Net cash (used in) provided by operating activities	-14,899	570
Cash flows from investing activities:	'	'
Cash paid for acquisitions	-2,234	'
Purchases of property and equipment	-10,367	-5,952
Net cash used in investing activities	-12,601	-5,952
Cash flows from financing activities:	'	'
Proceeds from stock option and purchase plans	3,045	5,530
Purchase of treasury stock	'	-522
Proceeds from the issuance of debt	1,136	'
Net cash provided by financing activities	4,181	5,008
Foreign exchange effect on cash and cash equivalents	39	144
Decrease in cash and cash equivalents	-23,280	-230
Cash and cash equivalents, beginning of period	106,439	102,909
Cash and cash equivalents, end of period	$83,159	$102,679

Nature_of_Operations

Nature of Operations	9 Months Ended
	Sep. 30, 2013
Accounting Policies [Abstract]	'
Nature of Operations	'
	1	Nature of Operations
	We are a medical device company that develops, manufactures and markets innovative products for the treatment of kidney failure, fluid overload and related blood treatments and procedures. Our primary product, the NxStage System One, or System One, was designed to satisfy an unmet clinical need for a system that can deliver the therapeutic flexibility and clinical benefits associated with traditional dialysis machines in a smaller, portable, easy-to-use form that can be used by healthcare professionals and trained lay users alike in a variety of settings, including patient homes, as well as more traditional care settings such as hospitals and dialysis clinics. Given its design, the System One is particularly well-suited for home hemodialysis and a range of dialysis therapies including more frequent dialysis, which clinical literature suggests provides patients better clinical outcomes and improved quality of life. The System One is cleared or approved for commercial sale in the United States, or U.S., Canada and certain other markets for the treatment of acute and chronic kidney failure and fluid overload. The System One is also CE marked in the European Union, or EU, for treatment of acute and chronic kidney failure and fluid overload. The System One is cleared specifically by the Food and Drug Administration, or FDA, for home hemodialysis as well as therapeutic plasma exchange, or TPE, in a clinical environment. The System One is also CE marked in the EU for nocturnal home hemodialysis. We also sell needles and blood tubing sets primarily to dialysis clinics for the treatment of end-stage renal disease, or ESRD. These products are cleared or approved for commercial sale in the U.S., Canada and certain other markets. These products are also CE marked in the EU. We believe our largest product market opportunity is for our System One used in the home dialysis market for the treatment of ESRD.
	Basis of Presentation
	The accompanying condensed consolidated financial statements as of September 30, 2013 and for the three and nine months then ended, and related notes, are unaudited but, in the opinion of our management, include all adjustments, consisting of normal recurring adjustments, that are necessary for fair statement of the interim periods presented. Our unaudited condensed consolidated financial statements have been prepared following the requirements of the Securities and Exchange Commission, or SEC, for interim reporting. As permitted under these rules, we have condensed or omitted certain footnotes and other financial information that are normally required by U.S. generally accepted accounting principles, or GAAP. Our accounting policies are described in the notes to the consolidated financial statements in our Annual Report on Form 10-K for the year ended December 31, 2012, or 2012 Form 10-K, and updated, as necessary, in this Quarterly Report on Form 10-Q. Operating results for any interim period are not necessarily indicative of results for the entire year or future periods. The December 31, 2012 condensed consolidated balance sheet contained herein was derived from audited financial statements, but does not include all disclosures that would be required for audited financial statements under GAAP. For further information, refer to the consolidated financial statements and footnotes thereto included in our 2012 Form 10-K.

Summary_of_Significant_Account

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2013
Accounting Policies [Abstract]	'
Summary of Significant Accounting Policies	'
	2	Summary of Significant Accounting Policies
	Principles of Consolidation and Basis of Presentation
	The accompanying condensed consolidated financial statements include the accounts of NxStage Medical, Inc. and our wholly-owned subsidiaries. All material intercompany transactions and balances have been eliminated in consolidation.
	Use of Estimates
	The preparation of our condensed consolidated financial statements in conformity with GAAP requires our management to make estimates and assumptions that affect reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.
	Concentration of Credit Risk
	Concentration of credit risk with respect to accounts receivable is primarily limited to certain customers to whom we make substantial sales. One customer represented 24% of accounts receivable at September 30, 2013, and two customers represented 16% and 12% of accounts receivable at December 31, 2012.
	Warranty Costs
	We accrue estimated costs that we may incur under our product warranty programs at the time the product revenue is recognized based on contractual rights and historical experience. Warranty expense is included in cost of revenues in the condensed consolidated statements of comprehensive loss. The following is a rollforward of our warranty accrual (in thousands):
	Balance at December 31, 2012		$	324
	Provision			349
	Usage			(352	)
	Balance at September 30, 2013		$	321
	Recent Accounting Pronouncements
	Effective January 1, 2013, we adopted revised guidance related to the presentation of significant reclassifications out of accumulated other comprehensive income. This guidance does not impact the requirements for reporting net income or other comprehensive income in the financial statements, however, it does require that we disclose, in either a single note or parenthetically on the face of the financial statements, the effect of significant amounts reclassified from each component of accumulated other comprehensive income based on its source and the income statement line items affected by the reclassification. This guidance is required to be applied prospectively, and we have elected to include the required disclosures in the notes to the financial statements. The implementation of this guidance introduces new disclosure requirements but does not impact the amounts in our financial statements.

Inventory

Inventory	9 Months Ended
	Sep. 30, 2013
Inventory Disclosure [Abstract]	'
Inventory	'
	3	Inventory
	Inventory includes material, labor and overhead, and is stated at lower of cost (first-in, first-out) or market. The components of inventory are as follows (in thousands):
			September 30,		December 31,
			2013		2012
	Purchased components		$	13,246	$	16,322
	Work in process			13,263		8,390
	Finished goods			10,588		8,792
	Total		$	37,097	$	33,504

Property_and_Equipment_and_Fie

Property and Equipment and Field Equipment	9 Months Ended
	Sep. 30, 2013
Property Plant And Equipment [Abstract]	'
Property and Equipment and Field Equipment	'
	4	Property and Equipment and Field Equipment
	Accumulated depreciation on property and equipment was $20.4 million and $17.3 million at September 30, 2013 and December 31, 2012, respectively. Accumulated depreciation on field equipment was $35.9 million and $33.8 million at September 30, 2013 and December 31, 2012, respectively.

Intangible_Assets

Intangible Assets	9 Months Ended
	Sep. 30, 2013
Goodwill And Intangible Assets Disclosure [Abstract]	'
Intangible Assets	'
	5	Intangible Assets
	Accumulated amortization of intangible assets was $16.8 million and $14.7 million at September 30, 2013 and December 31, 2012, respectively.

Net_Loss_Per_Share

Net Loss Per Share	9 Months Ended
	Sep. 30, 2013
Earnings Per Share [Abstract]	'
Net Loss Per Share	'
	6	Net Loss per Share
	Basic net loss per share is computed by dividing loss available to common stockholders (the numerator) by the weighted-average number of common shares outstanding (the denominator) for the period. The computation of diluted loss per share is similar to basic loss per share, except that the denominator is increased to include the number of additional common shares that would have been outstanding if the potentially dilutive common shares had been issued.
	The following potential common stock equivalents, as calculated using the treasury stock method, were not included in the computation of diluted net loss per share as their effect would have been anti-dilutive due to the net loss incurred (in thousands):
			Three Months Ended September 30,				Nine Months Ended September 30,
			2013		2012		2013		2012
	Options to purchase common stock			1,104		1,313		1,053		1,771
	Unvested restricted stock			177		239		136		191
	Warrants to purchase common stock			—		875		—		959
	Total			1,281		2,427		1,189		2,921

Accrued_Expenses

Accrued Expenses	9 Months Ended
	Sep. 30, 2013
Text Block [Abstract]	'
Accrued Expenses	'
	7	Accrued expenses
	The components of accrued expenses are as follows (in thousands):
			September 30,		December 31,
			2013		2012
	Payroll, compensation and related benefits		$	8,282	$	8,320
	Distribution expenses			2,360		3,175
	Contingent consideration (Payable to Seller)			576		—
	General and administrative expenses			2,462		2,337
	Accrued taxes			681		2,475
	Other			3,799		4,093
	Total		$	18,160	$	20,400

Debt

Debt	9 Months Ended
	Sep. 30, 2013
Debt Disclosure [Abstract]	'
Debt	'
	8	Debt
	We entered into two euro denominated mortgages collateralized by a manufacturing facility in Italy that we acquired in May 2013. The first mortgage is in the principal amount of $0.6 million, subject to an annual interest rate of 6.0%, and payable quarterly over a 10 year period. The second mortgage is in the principal amount of $0.5 million, subject to an annual interest rate of 2.0%, and payable biannually over a 10 year period.

Segment_Disclosures

Segment Disclosures	9 Months Ended
	Sep. 30, 2013
Segment Reporting [Abstract]	'
Segment Disclosures	'
	9	Segment Disclosures
	We have two reportable business segments: System One and In-Center.
	Our System One segment includes revenues from the sale and rental of the System One and PureFlow SL equipment and the sale of disposable products in the home and critical care markets. The home market is devoted to the treatment of ESRD patients in the home, while the critical care market is devoted to the treatment of hospital-based patients with acute kidney failure or fluid overload. Some of our largest customers in the home market provide outsourced renal dialysis services to some of our customers in the critical care market. Sales of product to both markets are made primarily through dedicated sales forces and distributed directly to the customer or the patient, with certain products sold through distributors internationally. The results of our international business are included in the System One segment.
	Our In-Center segment includes revenues from the sale of blood tubing sets and needles for hemodialysis primarily for the treatment of ESRD patients at dialysis centers and needles for apheresis. Nearly all In-Center products are sold through national distributors.
	The remainder of our operations and financial information, included within the Other category, relates primarily to (1) the manufacturing of dialyzers for sale to Asahi Kuraray Medical Co., or Asahi, (2) certain business development activities, including our continuing work on establishing centers of excellence, which are dialysis clinics focused on the provision of home therapy and flexible in-center options, and (3) research and development and general and administrative expenses that are excluded from the segment operating performance measures.
	The accounting policies of our reportable segments are the same as those described in Note 2 to the consolidated financial statements included in our 2012 Form 10-K. Our chief operating decision maker allocates resources to our business segments and assesses segment performance based on segment profit (loss), which consists of revenues less cost of revenues, selling and marketing and distribution expenses.
	The following summarizes the operating performance of our reportable segments (in thousands):
			System One			In-Center			Other			Total
	Three Months Ended September 30, 2013
	Revenues from external customers		$	44,337		$	21,269		$	1,267		$	66,873
	Segment profit (loss)			5,518			4,214			(14,145	)		(4,413	)
	Depreciation and amortization			4,511			332			1,328			6,171
	Three Months Ended September 30, 2012
	Revenues from external customers		$	41,024		$	19,637		$	491		$	61,152
	Segment profit (loss)			6,330			2,905			(11,581	)		(2,346	)
	Depreciation and amortization			4,584			362			969			5,915
	Nine Months Ended September 30, 2013
	Revenues from external customers		$	130,003		$	61,207		$	2,769		$	193,979
	Segment profit (loss)			17,644			11,950			(42,814	)		(13,220	)
	Depreciation and amortization			13,440			1,014			3,976			18,430
	Nine Months Ended September 30, 2012
	Revenues from external customers		$	120,428		$	55,477		$	1,207		$	177,112
	Segment profit (loss)			17,716			6,848			(33,860	)		(9,296	)
	Depreciation and amortization			13,605			1,069			2,821			17,495
	Substantially all of our revenues have been derived from the sale of the System One and related products, which cannot be used with any other dialysis system, and from needles and blood tubing sets to customers located in the U.S.
	The following table summarizes the customers who individually comprise greater than 10% of total revenues and their respective portion of total revenues:
			Three Months Ended September 30,						Nine Months Ended September 30,
			2013			2012			2013			2012
	Customer A			21	%		20	%		22	%		20	%
	Customer B			8	%		11	%		10	%		10	%
	Customer C			13	%		11	%		13	%		12	%
	Customer D			14	%		11	%		13	%		11	%
	Sales to Customer A and D are nearly all in the System One segment and sales to Customer B and C are to significant distributors in the In-Center segment. A portion of Customer B’s sales of our products are to Customer A. All of Customer C’s sales of our products are to Customer A.

Commitments_and_Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2013
Commitments And Contingencies Disclosure [Abstract]	'
Commitments and Contingencies	'
	10	Commitments and Contingencies
	As discussed in our 2012 Form 10-K, a civil complaint was filed against us on February 28, 2012 in the US District Court for the District of Massachusetts by Gambro Renal Products, Inc., or Gambro (Case No. 1:12cv10370-PBS). The complaint alleges that we violated Section 43(a) of the Lanham Act, 15 U.S.C. § 1125(a), and Massachusetts General Laws Chapter 93A by making false and misleading statements about our and Gambro’s allegedly competing products in the critical care market in commercial and promotional activities. The complaint also alleges that we wrongfully interfered with contractual and advantageous relationships of Gambro in its critical care business. Gambro seeks compensatory and treble damages, disgorgement of profits and injunctive relief. We believe the suit is without merit and intend to defend against it vigorously. At this time we do not believe a loss is probable and we are not able to estimate a range of possible loss.
	Other significant commitments and contingencies at September 30, 2013 are consistent with those discussed in Note 10 to the consolidated financial statements in our 2012 Form 10-K.

Income_Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2013
Income Tax Disclosure [Abstract]	'
Income Taxes	'
	11	Income Taxes
	We recognized a provision for income taxes of $0.3 million during the three months ended September 30, 2013 and a benefit from income taxes of $0.6 million during the nine months ended September 30, 2013 compared to a provision for income taxes of $0.2 million and $0.7 million for the three and nine months ended September 30, 2012, respectively. We recorded income tax expense during both 2013 and 2012 for certain profitable foreign subsidiaries. The net benefit from income taxes recorded during 2013 includes the favorable conclusion of a foreign income tax audit in the second quarter which resulted in the recognition of a $1.2 million income tax benefit.
	While we had a gross reserve for unrecognized tax benefits of $1.5 million as of December 31, 2012, we have no reserve for unrecognized tax benefits as of September 30, 2013.

StockBased_Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2013
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]	'
Stock-Based Compensation	'
	12	Stock-Based Compensation
	Stock-based Compensation Expense
	Our stock-based compensation expense is allocated among the following components of our condensed consolidated statements of comprehensive loss (in thousands):
			Three Months Ended September 30,				Nine Months Ended September 30,
			2013		2012		2013		2012
	Cost of revenues		$	219	$	299	$	774	$	944
	Selling and marketing			928		1,179		2,689		3,578
	Research and development			357		345		1,242		1,094
	General and administrative			891		1,138		3,125		3,597
	Total		$	2,395	$	2,961	$	7,830	$	9,213
	Stock Options and Restricted Stock Units
	The Company granted options to purchase 112,033 and 55,037 shares of common stock during the three months ended September 30, 2013 and 2012, respectively, and 1,103,315 and 451,519 shares of common stock during the nine months ended September 30, 2013 and 2012, respectively. The weighted-average fair value of options granted during the nine months ended September 30, 2013 and 2012 was $6.29 and $9.31 per option, respectively.
	The Company awarded 62,140 and 53,117 restricted stock units during the three months ended September 30, 2013 and 2012, respectively, and 289,905 and 176,498 restricted stock units during the nine months ended September 30, 2013 and 2012, respectively, which vest based on continued employment over a period of four years. The weighted-average fair value of these restricted stock units awarded during the nine months ended September 30, 2013 and 2012 was $11.91 and $17.19 per unit, respectively.
	Performance Based Plans
	In March 2013, the Compensation Committee of our Board of Directors approved the grant of up to 433,267 restricted stock units pursuant to performance based awards subject to the achievement of certain Company financial performance metrics for the year ending December 31, 2013. The restricted stock units, if earned, vest over a requisite service period of three years and have a fair value of $11.03 per unit. The estimated expense will be recognized as stock-based compensation expense over the requisite three year service period based on the number of shares expected to vest. Further, in March 2013, the Compensation Committee made awards subject to individual performance and the achievement of certain Company financial performance metrics for the year ending December 31, 2013. Awards are payable in shares of the Company’s common stock or in cash, at the discretion of the Compensation Committee. The estimated payout of these awards is being recognized as compensation expense during 2013, with a majority of this compensation expense classified as stock-based compensation expense, and has been classified as a liability on the Company’s condensed consolidated balance sheet.

Stockholders_Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2013
Equity [Abstract]	'
Stockholders' Equity	'
	13	Stockholders’ Equity
	We received 34,311 and 32,310 shares of common stock that were surrendered in payment for the exercise of stock options through the nine months ended September 30, 2013 and 2012, respectively.

Business_Combination

Business Combination	9 Months Ended
	Sep. 30, 2013
Business Combinations [Abstract]	'
Business Combination	'
	14	Business Combination
	On April 2, 2013, we acquired substantially all of the System One assets of Kimal PLC, or Kimal, a distributor of our products in the United Kingdom. The aggregate purchase price is estimated at $3.9 million. The acquisition is consistent with our move to a direct sales model in the United Kingdom.
	The acquisition was accounted for using the purchase method of accounting in accordance with the Financial Accounting Standards Board’s (“FASB”) guidance regarding business combinations. Our financial statements include the results of operations of Kimal subsequent to the acquisition date. We have not provided pro forma financial information for this acquisition given its results are not material to our consolidated financial statements. Transaction costs associated with this acquisition were expensed as incurred and are not material for the three or nine month periods ended September 30, 2013.
	The purchase price includes an initial cash payment of $2.2 million paid in July 2013, the forgiveness of a capital lease liability due from Kimal of $1.4 million, up to $0.7 million in deferred payments payable within 12 months of the acquisition date subject to certain post-closing conditions and the reclassification of deferred revenues of $0.3 million, net of related deferred cost of revenues, associated with sales of equipment to Kimal prior to January 1, 2011.
	The following is a summary of the estimated purchase price as of April 2, 2013, the date of acquisition (in thousands):
	Cash		$	2,181
	Fair value of lease liability forgiven			1,447
	Fair value of contingent consideration (payable to seller)			540
	Other			(307	)
	Total Purchase Price		$	3,861
	The following table presents the preliminary allocation of the purchase price to the estimated fair value of the assets acquired at April 2, 2013, the date of acquisition (in thousands):
	Assets purchased:
	Inventory		$	523
	Field Equipment			3,168
	Customer relationships			170
	Assets acquired		$	3,861
	The fair values of inventory and field equipment noted above approximate their net book value at the time of acquisition. The $0.2 million of customer relationships was valued using the multi-period excess-earnings method, a form of the income approach, using certain significant unobservable inputs (classified as level 3 in the fair value hierarchy), namely, a discount rate of 11.5%, projected future cash flows, and patient growth rates. The preliminary purchase price allocation is subject to adjustment based on a final valuations of assets purchased.

Derivative_Instruments_and_Hed

Derivative Instruments and Hedging	9 Months Ended
	Sep. 30, 2013
Derivative Instruments And Hedging Activities Disclosure [Abstract]	'
Derivative Instruments and Hedging	'
	15	Derivative Instruments and Hedging
	We operate a manufacturing and service facility in Mexico where we purchase materials and pay our employees in Pesos, and as such, we are potentially exposed to adverse as well as beneficial movements in foreign currency exchange rates. To minimize the impact of foreign currency exchange rate fluctuations on these Peso denominated expenses, we entered into foreign exchange forward contracts. These contracts have a duration of up to twelve months and are designated as cash flow hedges. The counterparties to these foreign exchange forward contracts are creditworthy financial institutions; therefore, we do not consider the risk of counterparty nonperformance to be material. As of September 30, 2013, the notional amount of our outstanding contracts that are designated as cash flow hedges was $11.4 million. The fair value of these contracts at September 30, 2013 included a liability of $0.3 million recorded on the balance sheet in accrued expenses. As of December 31, 2012, the notional amount of our outstanding contracts that were designated as cash flow hedges was approximately $7.8 million. The fair value of these contracts at December 31, 2012 was an asset of $0.4 million recorded on the balance sheet in prepaid expenses and other current assets. Gains or losses related to hedge ineffectiveness recognized in earnings were not material during the nine months ended September 30, 2013 or 2012. Given the short-term nature of our contracts, any gains or losses recorded within accumulated other comprehensive income (loss) will be recognized in earnings within the next twelve months.
	The following table presents the effect of these contracts designated as cash flow hedges on our condensed consolidated financial statements (in thousands):
			Gain (Loss)			Gain (Loss)		Classification within the
			Recognized in OCI			Reclassified from OCI		Condensed Consolidated
			(Effective Portion)			into Income		Statement of
						(Effective Portion)		Comprehensive Loss
	Three Months Ended September 30, 2013
	Foreign exchange forward contracts		$	(153	)	$	43	Cost of revenues
	Nine Months Ended September 30, 2013
	Foreign exchange forward contracts		$	3		$	684	Cost of revenues

Accumulated_Other_Comprehensiv

Accumulated Other Comprehensive (Loss) Income	9 Months Ended
	Sep. 30, 2013
Equity [Abstract]	'
Accumulated Other Comprehensive (Loss) Income	'
	16	Accumulated Other Comprehensive (Loss) Income
	The following additional information is provided with respect to the accumulated other comprehensive (loss) income as presented on the condensed consolidated balance sheets (in thousands):
			Unrealized gain (loss)			Other (2)		Total
			on derivative
			instruments
	Balance as of December 31, 2012		$	389		$	81	$	470
	Other comprehensive income before reclassifications			3			379		382
	Gain reclassified to earnings (1)			(684	)		—		(684	)
	Total other comprehensive income (loss)			(681	)		379		(302	)
	Balance as of September 30, 2013		$	(292	)	$	460	$	168
	-1	Reclassifications of gains (losses) on derivative instruments are included in cost of revenues on the condensed consolidated statement of comprehensive loss. See Note 15 for further information.
	-2	Other includes cumulative translation adjustments and pension benefits.

Fair_Value_Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2013
Fair Value Disclosures [Abstract]	'
Fair Value Measurements	'
	17	Fair Value Measurements
	We have certain financial and non-financial assets and liabilities measured at fair value on a recurring and non-recurring basis recorded in our condensed consolidated balance sheets. The fair value measurements used are based on quoted prices, when available, or through the use of alternative approaches. The inputs used to determine fair value have been classified as Level 1, 2 or 3. Fair values determined by Level 1 inputs utilize quoted prices (unadjusted) in active markets for identical assets or liabilities that we have the ability to access. Fair values determined by Level 2 inputs utilize data points that are observable such as quoted prices, interest rates and yield curves for similar instruments and model-derived valuations whose inputs are observable. Fair values determined by Level 3 inputs utilize unobservable data points for the asset or liability.
	We measure the fair value of our foreign exchange forward contracts classified as derivative instruments using an income approach, based on prevailing market forward rates less the contract rate multiplied by the notional amount. The product of this calculation is then adjusted for counterparty risk.
	Our contingent consideration liability relates to deferred payments in connection with our acquisition of substantially all of the System One assets of Kimal on April 2, 2013. We recognized a liability equal to the estimated fair value of the contingent payment we expect to make as of the acquisition date and we re-measure this liability each reporting period with changes in the fair value recorded in earnings. There were no significant changes in our contingent consideration liability during the three and nine months ended September 30, 2013. The liability recorded at acquisition and at September 30, 2013 was measured using probability weighted discounted cash flow method and includes certain significant unobservable inputs, namely, a discount rate of 11.5% and patient growth rates.
	We did not have any transfers between Level 1 and Level 2 or transfers in or out of Level 3, excluding the contingent consideration liability, during the nine months ended September 30, 2013.
	The following table presents assets and liabilities measured at fair value on a recurring basis and their level within the value hierarchy (in thousands):
	September 30, 2013		Quoted Prices in		Significant Other		Significant		Total
			Active Markets for		Observable Inputs		Unobservable		Fair Value
			Identical Assets		(Level 2)		Inputs
			(Level 1)				(Level 3)
	Assets
	Money market funds (1)		$	73,778	$	—	$	—	$	73,778
	Foreign exchange forward contracts (2)			—		25		—		25
	Liabilities
	Foreign exchange forward contracts (2)		$	—	$	358	$	—	$	358
	Contingent consideration liability (3)			—		—		576		576
	-1	Money market funds are included within cash and cash equivalents.
	-2	Foreign exchange forward contracts are included within prepaid expenses and other current assets or accrued expenses depending on the gain (loss) position.
	-3	Net present value of expected payments under contingent consideration liability are reported in accrued expenses.
	Assets measured at fair value on a non-recurring basis in the current period include the assets acquired in a business combination, as described in Note 14.
	The carrying amounts reflected in the condensed consolidated balance sheets for cash and cash equivalents, accounts receivable, prepaid expenses and other current and non-current assets, accounts payable and accrued expenses approximate fair value due to their short-term nature.

Supplemental_Cash_Flow_Informa

Supplemental Cash Flow Information	9 Months Ended
	Sep. 30, 2013
Supplemental Cash Flow Elements [Abstract]	'
Supplemental Cash Flow Information	'
	18	Supplemental Cash Flow Information
	The following additional information is provided with respect to the condensed consolidated statements of cash flows (in thousands):
			Nine Months Ended September 30,
			2013		2012
	Noncash Investing and Financing Activities:
	Transfers from inventory to field equipment		$	9,315	$	8,183
	Transfers from field equipment to deferred cost of revenues			6,012		7,279
	Payment of corporate bonus in common stock			1,034		878
	Market value of shares received in payment for exercise of stock options			412		513
	Construction-in-process financed by construction liability			2,604		7,235
	Payment of Asahi debt through the issuance of equity			—		45,219
	Leasehold improvements paid by the landlord			—		4,300
	Property and equipment acquired under capital lease			745		1,210
	Acquisition of business			3,861		—
	Deferred revenues and deferred costs related to acquiree recorded as a reduction of consideration paid			335		—

Summary_of_Significant_Account1

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2013
Accounting Policies [Abstract]	'
Principles of Consolidation and Basis of Presentation	'
	Principles of Consolidation and Basis of Presentation
	The accompanying condensed consolidated financial statements include the accounts of NxStage Medical, Inc. and our wholly-owned subsidiaries. All material intercompany transactions and balances have been eliminated in consolidation.
Use of Estimates	'
	Use of Estimates
	The preparation of our condensed consolidated financial statements in conformity with GAAP requires our management to make estimates and assumptions that affect reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.
Concentration of Credit Risk	'
	Concentration of Credit Risk
	Concentration of credit risk with respect to accounts receivable is primarily limited to certain customers to whom we make substantial sales. One customer represented 24% of accounts receivable at September 30, 2013, and two customers represented 16% and 12% of accounts receivable at December 31, 2012.
Warranty Costs	'
	Warranty Costs
	We accrue estimated costs that we may incur under our product warranty programs at the time the product revenue is recognized based on contractual rights and historical experience. Warranty expense is included in cost of revenues in the condensed consolidated statements of comprehensive loss.
Recent Accounting Pronouncements	'
	Recent Accounting Pronouncements
	Effective January 1, 2013, we adopted revised guidance related to the presentation of significant reclassifications out of accumulated other comprehensive income. This guidance does not impact the requirements for reporting net income or other comprehensive income in the financial statements, however, it does require that we disclose, in either a single note or parenthetically on the face of the financial statements, the effect of significant amounts reclassified from each component of accumulated other comprehensive income based on its source and the income statement line items affected by the reclassification. This guidance is required to be applied prospectively, and we have elected to include the required disclosures in the notes to the financial statements. The implementation of this guidance introduces new disclosure requirements but does not impact the amounts in our financial statements.

Summary_of_Significant_Account2

Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2013
Accounting Policies [Abstract]	'
Schedule of Rollforward of Warranty Accrual	'
	The following is a rollforward of our warranty accrual (in thousands):
	Balance at December 31, 2012	$	324
	Provision		349
	Usage		(352	)
	Balance at September 30, 2013	$	321

Inventory_Tables

Inventory (Tables)	9 Months Ended
	Sep. 30, 2013
Inventory Disclosure [Abstract]	'
Components of Inventory	'
	The components of inventory are as follows (in thousands):
		September 30,		December 31,
		2013		2012
	Purchased components	$	13,246	$	16,322
	Work in process		13,263		8,390
	Finished goods		10,588		8,792
	Total	$	37,097	$	33,504

Net_Loss_Per_Share_Tables

Net Loss Per Share (Tables)	9 Months Ended
	Sep. 30, 2013
Earnings Per Share [Abstract]	'
Schedule of Anti-dilutive Net Loss Per Share	'
	The following potential common stock equivalents, as calculated using the treasury stock method, were not included in the computation of diluted net loss per share as their effect would have been anti-dilutive due to the net loss incurred (in thousands):
		Three Months Ended September 30,				Nine Months Ended September 30,
		2013		2012		2013		2012
	Options to purchase common stock		1,104		1,313		1,053		1,771
	Unvested restricted stock		177		239		136		191
	Warrants to purchase common stock		—		875		—		959
	Total		1,281		2,427		1,189		2,921

Accrued_Expenses_Tables

Accrued Expenses (Tables)	9 Months Ended
	Sep. 30, 2013
Text Block [Abstract]	'
Components of Accrued Expenses	'
	The components of accrued expenses are as follows (in thousands):
		September 30,		December 31,
		2013		2012
	Payroll, compensation and related benefits	$	8,282	$	8,320
	Distribution expenses		2,360		3,175
	Contingent consideration (Payable to Seller)		576		—
	General and administrative expenses		2,462		2,337
	Accrued taxes		681		2,475
	Other		3,799		4,093
	Total	$	18,160	$	20,400

Segment_Disclosures_Tables

Segment Disclosures (Tables)	9 Months Ended
	Sep. 30, 2013
Segment Reporting [Abstract]	'
Summary of Operating Performance of Reportable Segment	'
	The following summarizes the operating performance of our reportable segments (in thousands):
		System One			In-Center			Other			Total
	Three Months Ended September 30, 2013
	Revenues from external customers	$	44,337		$	21,269		$	1,267		$	66,873
	Segment profit (loss)		5,518			4,214			(14,145	)		(4,413	)
	Depreciation and amortization		4,511			332			1,328			6,171
	Three Months Ended September 30, 2012
	Revenues from external customers	$	41,024		$	19,637		$	491		$	61,152
	Segment profit (loss)		6,330			2,905			(11,581	)		(2,346	)
	Depreciation and amortization		4,584			362			969			5,915
	Nine Months Ended September 30, 2013
	Revenues from external customers	$	130,003		$	61,207		$	2,769		$	193,979
	Segment profit (loss)		17,644			11,950			(42,814	)		(13,220	)
	Depreciation and amortization		13,440			1,014			3,976			18,430
	Nine Months Ended September 30, 2012
	Revenues from external customers	$	120,428		$	55,477		$	1,207		$	177,112
	Segment profit (loss)		17,716			6,848			(33,860	)		(9,296	)
	Depreciation and amortization		13,605			1,069			2,821			17,495
Summary of Customers Who Individually Makeup Greater than 10% of Total Revenues and Their Respective Portion of Total Revenues	'
	The following table summarizes the customers who individually comprise greater than 10% of total revenues and their respective portion of total revenues:
		Three Months Ended September 30,						Nine Months Ended September 30,
		2013			2012			2013			2012
	Customer A		21	%		20	%		22	%		20	%
	Customer B		8	%		11	%		10	%		10	%
	Customer C		13	%		11	%		13	%		12	%
	Customer D		14	%		11	%		13	%		11	%

StockBased_Compensation_Tables

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2013
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]	'
Summary of Stock-Based Compensation Expense in Consolidated Statements of Comprehensive Loss	'
	Our stock-based compensation expense is allocated among the following components of our condensed consolidated statements of comprehensive loss (in thousands):
		Three Months Ended September 30,				Nine Months Ended September 30,
		2013		2012		2013		2012
	Cost of revenues	$	219	$	299	$	774	$	944
	Selling and marketing		928		1,179		2,689		3,578
	Research and development		357		345		1,242		1,094
	General and administrative		891		1,138		3,125		3,597
	Total	$	2,395	$	2,961	$	7,830	$	9,213

Business_Combination_Tables

Business Combination (Tables)	9 Months Ended
	Sep. 30, 2013
Business Combinations [Abstract]	'
Summary of Purchase Price	'
	The following is a summary of the estimated purchase price as of April 2, 2013, the date of acquisition (in thousands):
	Cash	$	2,181
	Fair value of lease liability forgiven		1,447
	Fair value of contingent consideration (payable to seller)		540
	Other		(307	)
	Total Purchase Price	$	3,861
Preliminary Allocation of Purchase Price to Estimated Fair Value of Assets Acquired	'
	The following table presents the preliminary allocation of the purchase price to the estimated fair value of the assets acquired at April 2, 2013, the date of acquisition (in thousands):
	Assets purchased:
	Inventory	$	523
	Field Equipment		3,168
	Customer relationships		170
	Assets acquired	$	3,861

Derivative_Instruments_and_Hed1

Derivative Instruments and Hedging (Tables)	9 Months Ended
	Sep. 30, 2013
Derivative Instruments And Hedging Activities Disclosure [Abstract]	'
Effect of Contracts Designated as Cash Flow Hedges on Condensed Consolidated Financial Statements	'
	The following table presents the effect of these contracts designated as cash flow hedges on our condensed consolidated financial statements (in thousands):
		Gain (Loss)			Gain (Loss)		Classification within the
		Recognized in OCI			Reclassified from OCI		Condensed Consolidated
		(Effective Portion)			into Income		Statement of
					(Effective Portion)		Comprehensive Loss
	Three Months Ended September 30, 2013
	Foreign exchange forward contracts	$	(153	)	$	43	Cost of revenues
	Nine Months Ended September 30, 2013
	Foreign exchange forward contracts	$	3		$	684	Cost of revenues

Accumulated_Other_Comprehensiv1

Accumulated Other Comprehensive (Loss) Income (Tables)	9 Months Ended
	Sep. 30, 2013
Equity [Abstract]	'
Summary of Additional Information on Accumulated Other Comprehensive Income	'
	The following additional information is provided with respect to the accumulated other comprehensive (loss) income as presented on the condensed consolidated balance sheets (in thousands):
			Unrealized gain (loss)			Other (2)		Total
			on derivative
			instruments
	Balance as of December 31, 2012		$	389		$	81	$	470
	Other comprehensive income before reclassifications			3			379		382
	Gain reclassified to earnings (1)			(684	)		—		(684	)
	Total other comprehensive income (loss)			(681	)		379		(302	)
	Balance as of September 30, 2013		$	(292	)	$	460	$	168
	-1	Reclassifications of gains (losses) on derivative instruments are included in cost of revenues on the condensed consolidated statement of comprehensive loss. See Note 15 for further information.
	-2	Other includes cumulative translation adjustments and pension benefits.

Fair_Value_Measurements_Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2013
Fair Value Disclosures [Abstract]	'
Schedule of Fair Value Assets and Liabilities Measured on Recurring Basis	'
	The following table presents assets and liabilities measured at fair value on a recurring basis and their level within the value hierarchy (in thousands):
	September 30, 2013		Quoted Prices in		Significant Other		Significant		Total
			Active Markets for		Observable Inputs		Unobservable		Fair Value
			Identical Assets		(Level 2)		Inputs
			(Level 1)				(Level 3)
	Assets
	Money market funds (1)		$	73,778	$	—	$	—	$	73,778
	Foreign exchange forward contracts (2)			—		25		—		25
	Liabilities
	Foreign exchange forward contracts (2)		$	—	$	358	$	—	$	358
	Contingent consideration liability (3)			—		—		576		576
	-1	Money market funds are included within cash and cash equivalents.
	-2	Foreign exchange forward contracts are included within prepaid expenses and other current assets or accrued expenses depending on the gain (loss) position.
	-3	Net present value of expected payments under contingent consideration liability are reported in accrued expenses.

Supplemental_Cash_Flow_Informa1

Supplemental Cash Flow Information (Tables)	9 Months Ended
	Sep. 30, 2013
Supplemental Cash Flow Elements [Abstract]	'
Summary of Supplemental Cash Flow Information	'
	The following additional information is provided with respect to the condensed consolidated statements of cash flows (in thousands):
		Nine Months Ended September 30,
		2013		2012
	Noncash Investing and Financing Activities:
	Transfers from inventory to field equipment	$	9,315	$	8,183
	Transfers from field equipment to deferred cost of revenues		6,012		7,279
	Payment of corporate bonus in common stock		1,034		878
	Market value of shares received in payment for exercise of stock options		412		513
	Construction-in-process financed by construction liability		2,604		7,235
	Payment of Asahi debt through the issuance of equity		—		45,219
	Leasehold improvements paid by the landlord		—		4,300
	Property and equipment acquired under capital lease		745		1,210
	Acquisition of business		3,861		—
	Deferred revenues and deferred costs related to acquiree recorded as a reduction of consideration paid		335		—

Summary_of_Significant_Account3

Summary of Significant Accounting Policies - Additional Information (Detail) (Accounts Receivable [Member])	9 Months Ended	12 Months Ended
	Sep. 30, 2013	Dec. 31, 2012
Major Customer One [Member]	'	'
Accounting Policies [Line Items]	'	'
Percentage of account receivable	24.00%	16.00%
Major Customer Two [Member]	'	'
Accounting Policies [Line Items]	'	'
Percentage of account receivable	'	12.00%

Summary_of_Significant_Account4

Summary of Significant Accounting Policies - Schedule of Rollforward of Warranty Accrual (Detail) (USD $)	9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2013
Guarantees [Abstract]	'
Balance at December 31, 2012	$324
Provision	349
Usage	-352
Balance at September 30, 2013	$321

Inventory_Components_of_Invent

Inventory - Components of Inventory (Detail) (USD $)	Sep. 30, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Inventory Disclosure [Abstract]	'	'
Purchased components	$13,246	$16,322
Work in process	13,263	8,390
Finished goods	10,588	8,792
Total	$37,097	$33,504

Property_and_Equipment_and_Fie1

Property and Equipment and Field Equipment - Additional Information (Detail) (USD $)	Sep. 30, 2013	Dec. 31, 2012
In Millions, unless otherwise specified
Property and Equipment [Member]	'	'
Depreciation and Amortization Expenses For Property Plant And Equipment [Line Items]	'	'
Accumulated depreciation	$20.40	$17.30
Field Equipment [Member]	'	'
Depreciation and Amortization Expenses For Property Plant And Equipment [Line Items]	'	'
Accumulated depreciation	$35.90	$33.80

Intangible_Assets_Additional_I

Intangible Assets - Additional Information (Detail) (USD $)	9 Months Ended	12 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2013	Dec. 31, 2012
Goodwill And Intangible Assets Disclosure [Abstract]	'	'
Amortization expense	$16.80	$14.70

Net_Loss_per_Share_Schedule_of

Net Loss per Share - Schedule of Anti-dilutive Net Loss Per Share (Detail)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Dilutive Securities Included And Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]	'	'	'	'
Total	1,281	2,427	1,189	2,921
Options to Purchase Common Stock [Member]	'	'	'	'
Dilutive Securities Included And Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]	'	'	'	'
Total	1,104	1,313	1,053	1,771
Unvested Restricted Stock [Member]	'	'	'	'
Dilutive Securities Included And Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]	'	'	'	'
Total	177	239	136	191
Warrants to Purchase Common Stock [Member]	'	'	'	'
Dilutive Securities Included And Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]	'	'	'	'
Total	'	875	'	959

Accrued_Expenses_Components_of

Accrued Expenses - Components of Accrued Expenses (Detail) (USD $)	Sep. 30, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Payables And Accruals [Abstract]	'	'
Payroll, compensation and related benefits	$8,282	$8,320
Distribution expenses	2,360	3,175
Contingent consideration (Payable to Seller)	576	'
General and administrative expenses	2,462	2,337
Accrued taxes	681	2,475
Other	3,799	4,093
Total	$18,160	$20,400

Debt_Additional_Information_De

Debt - Additional Information (Detail) (USD $)	9 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2013	30-May-13
Mortgage One [Member]	'	'
Debt Instrument [Line Items]	'	'
Mortgage Loan	'	$0.60
Mortgage Loan Period	'10 years	'
Interest rate on mortgage loan	6.00%	'
Frequency of periodic payments	'Payable quarterly over a 10 year period	'
Mortgage Two [Member]	'	'
Debt Instrument [Line Items]	'	'
Mortgage Loan	'	$0.50
Mortgage Loan Period	'10 years	'
Interest rate on mortgage loan	2.00%	'
Frequency of periodic payments	'Payable biannually over a 10 year period	'

Segment_Disclosures_Additional

Segment Disclosures - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2013
	Segment
Segment Reporting [Abstract]	'
Number of reporting segments	2

Segment_Disclosures_Summary_of

Segment Disclosures - Summary of Operating Performance of Reportable Segment (Detail) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Segment Reporting Information [Line Items]	'	'	'	'
Revenues from external customers	$66,873	$61,152	$193,979	$177,112
Segment profit (loss)	-4,413	-2,346	-13,220	-9,296
Depreciation and amortization	6,171	5,915	18,430	17,495
System One [Member]	'	'	'	'
Segment Reporting Information [Line Items]	'	'	'	'
Revenues from external customers	44,337	41,024	130,003	120,428
Segment profit (loss)	5,518	6,330	17,644	17,716
Depreciation and amortization	4,511	4,584	13,440	13,605
In-Center [Member]	'	'	'	'
Segment Reporting Information [Line Items]	'	'	'	'
Revenues from external customers	21,269	19,637	61,207	55,477
Segment profit (loss)	4,214	2,905	11,950	6,848
Depreciation and amortization	332	362	1,014	1,069
Other [Member]	'	'	'	'
Segment Reporting Information [Line Items]	'	'	'	'
Revenues from external customers	1,267	491	2,769	1,207
Segment profit (loss)	-14,145	-11,581	-42,814	-33,860
Depreciation and amortization	$1,328	$969	$3,976	$2,821

Segment_Disclosures_Summary_of1

Segment Disclosures - Summary of Customers Who Individually Make Up Greater Than 10% of Total Revenues and Their Respective Portion of Total Revenues (Detail) (Sales [Member])	3 Months Ended		9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Customer A [Member]	'	'	'	'
Entity Wide Portfolio Carrying Amount, Major Customer [Line Items]	'	'	'	'
Percentage of revenues	21.00%	20.00%	22.00%	20.00%
Customer B [Member]	'	'	'	'
Entity Wide Portfolio Carrying Amount, Major Customer [Line Items]	'	'	'	'
Percentage of revenues	8.00%	11.00%	10.00%	10.00%
Customer C [Member]	'	'	'	'
Entity Wide Portfolio Carrying Amount, Major Customer [Line Items]	'	'	'	'
Percentage of revenues	13.00%	11.00%	13.00%	12.00%
Customer D [Member]	'	'	'	'
Entity Wide Portfolio Carrying Amount, Major Customer [Line Items]	'	'	'	'
Percentage of revenues	14.00%	11.00%	13.00%	11.00%

Income_Taxes_Additional_Inform

Income Taxes - Additional Information (Detail) (USD $)	3 Months Ended		9 Months Ended			3 Months Ended
	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012	Dec. 31, 2012	Jun. 30, 2013
						Foreign Audit [Member]
Schedule of Income Tax [Line Items]	'	'	'	'	'	'
(Benefit from) provision for income taxes	$269,000	$223,000	($625,000)	$700,000	'	'
Foreign tax expense (benefit)	'	'	'	'	'	1,200,000
Unrecognized tax benefits	'	'	'	'	$1,500,000	'

StockBased_Compensation_Summar

Stock-Based Compensation - Summary of Stock-Based Compensation Expense in the Consolidated Statements of Comprehensive Loss (Detail) (USD $)	3 Months Ended		9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012	Sep. 30, 2013	Sep. 30, 2012
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]	'	'	'	'
Total stock-based compensation expense	$2,395	$2,961	$7,830	$9,213
Cost of Revenues [Member]	'	'	'	'
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]	'	'	'	'
Total stock-based compensation expense	219	299	774	944
Selling and Marketing [Member]	'	'	'	'
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]	'	'	'	'
Total stock-based compensation expense	928	1,179	2,689	3,578
Research and Development [Member]	'	'	'	'
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]	'	'	'	'
Total stock-based compensation expense	357	345	1,242	1,094
General and Administrative [Member]	'	'	'	'
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]	'	'	'	'
Total stock-based compensation expense	$891	$1,138	$3,125	$3,597

StockBased_Compensation_Additi

Stock-Based Compensation - Additional Information (Detail) (USD $)

1 Months Ended

3 Months Ended

9 Months Ended

3 Months Ended

9 Months Ended

Mar. 31, 2013

Sep. 30, 2013

Sep. 30, 2012

Sep. 30, 2013

Sep. 30, 2012

Sep. 30, 2013

Sep. 30, 2012

Sep. 30, 2013

Sep. 30, 2012

Sep. 30, 2013

Sep. 30, 2013

Sep. 30, 2013

2013 Performance Share Plan [Member]

Options to Purchase Common Stock [Member]

Options to Purchase Common Stock [Member]

Options to Purchase Common Stock [Member]

Options to Purchase Common Stock [Member]

Restricted Stock Units (RSUs) [Member]

Restricted Stock Units (RSUs) [Member]

Restricted Stock Units (RSUs) [Member]

Restricted Stock Units (RSUs) [Member]

Restricted Stock Units (RSUs) [Member]

Restricted Stock Units (RSUs) [Member]

Restricted Stock Units (RSUs) [Member]

2013 Performance Share Plan [Member]

Maximum [Member]

Minimum [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

'

'

'

'

'

'

'

'

'

'

'

'

Options, grants in period

433,267

112,033

55,037

1,103,315

451,519

62,140

53,117

289,905

176,498

'

'

'

Weighted-average fair value of options granted

'

'

'

$6.29

$9.31

'

'

'

'

'

'

'

Weighted-average fair value of restricted stock units

'

'

'

'

'

'

'

$11.91

$17.19

$11.03

'

'

Restricted stock vests over a requisite service period

'

'

'

'

'

'

'

'

'

'

'4 years

'3 years

Stock-based compensation expense recognition period

'

'

'

'

'

'

'

'

'

'3 years

'

'

Stockholders_Equity_Additional

Stockholder's Equity - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2013	Sep. 30, 2012
Equity [Abstract]	'	'
Additional shares surrendered by employees in payment for the exercise of stock options	34,311	32,310

Business_Combination_Additiona

Business Combination - Additional Information (Detail) (USD $)	0 Months Ended	1 Months Ended	9 Months Ended
	Apr. 02, 2013	Jul. 31, 2013	Sep. 30, 2013
Loans At Acquisition Date [Line Items]	'	'	'
Purchase price	$3,900,000	'	'
Purchase price includes cash payment	'	'	2,234,000
Discount Rate used for calculating fair value of Customer relationship	'	'	11.50%
Customer Relationships [Member]	'	'	'
Loans At Acquisition Date [Line Items]	'	'	'
Discount Rate used for calculating fair value of Customer relationship	'	'	11.50%
Kimal PLC [Member]	'	'	'
Loans At Acquisition Date [Line Items]	'	'	'
Purchase price includes cash payment	2,181,000	2,200,000	'
Forgiveness of capital lease liability	1,447,000	'	1,447,000
Deferred payment	'	'	700,000
Reclassification of deferred revenues, net of related deferred cost of revenues associated with sales of equipment	'	'	300,000
Customer Relationship, Fair value	170,000	'	'
Kimal PLC [Member] | Customer Relationships [Member] | Significant Unobservable Inputs (Level 3) [Member]	'	'	'
Loans At Acquisition Date [Line Items]	'	'	'
Customer Relationship, Fair value	'	'	$200,000

Business_Combination_Summary_o

Business Combination - Summary of Purchase Price (Detail) (USD $)	0 Months Ended	1 Months Ended	9 Months Ended
In Thousands, unless otherwise specified	Apr. 02, 2013	Jul. 31, 2013	Sep. 30, 2013
Loans At Acquisition Date [Line Items]	'	'	'
Cash	'	'	$2,234
Kimal PLC [Member]	'	'	'
Loans At Acquisition Date [Line Items]	'	'	'
Cash	2,181	2,200	'
Fair value of lease liability forgiven	1,447	'	1,447
Fair value of contingent consideration (payable to seller)	540	'	'
Other	-307	'	'
Total Purchase Price	$3,861	'	'

Business_Combination_Prelimina

Business Combination - Preliminary Allocation of Purchase Price to Estimated Fair Value of Assets Acquired (Detail) (Kimal PLC [Member], USD $)	Apr. 02, 2013
In Thousands, unless otherwise specified
Kimal PLC [Member]	'
Assets purchased:	'
Inventory	$523
Field Equipment	3,168
Customer relationships	170
Assets acquired	$3,861

Derivative_Instruments_and_Hed2

Derivative Instruments and Hedging - Additional Information (Detail) (USD $)	9 Months Ended
In Millions, unless otherwise specified	Sep. 30, 2013	Dec. 31, 2012
Hedging Transactions And Derivative Financial Instruments [Line Items]	'	'
Period of cash flow hedges	'12 months	'
Fair value of contracts, derivative liability	$0.30	'
Fair value of contracts, derivative asset	'	0.4
Cash Flow Hedges [Member]	'	'
Hedging Transactions And Derivative Financial Instruments [Line Items]	'	'
Notional amount of outstanding contracts	$11.40	$7.80

Derivative_Instruments_and_Hed3

Derivative Instruments and Hedging - Effect of Contracts Designated as Cash Flow Hedges on Condensed Consolidated Financial Statements (Detail) (Cost of Revenues [Member], Foreign Exchange Forward Contracts [Member], Cash Flow Hedges [Member], USD $)	3 Months Ended	9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2013
Cost of Revenues [Member] | Foreign Exchange Forward Contracts [Member] | Cash Flow Hedges [Member]	'	'
Derivative Instruments, Gain (Loss) [Line Items]	'	'
Gain (Loss) Recognized in OCI (Effective Portion)	($153)	$3
Gain (Loss) Reclassified from OCI into Income (Effective Portion)	$43	$684
Classification within the Condensed Consolidated Statement of Comprehensive Loss	'Cost of revenues	'Cost of revenues

Accumulated_Other_Comprehensiv2

Accumulated Other Comprehensive (Loss) Income - Summary of Additional Information on Accumulated Other Comprehensive Income (Detail) (USD $)	9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2013
Accumulated Other Comprehensive Income (Loss) [Line Items]	'
Beginning balance	$470
Other comprehensive income before reclassifications	382
Gain reclassified to earnings	-684
Total other comprehensive income (loss)	-302
Ending Balance	168
Accumulated Translation Adjustment and Defined Benefit Plans Adjustment [Member]	'
Accumulated Other Comprehensive Income (Loss) [Line Items]	'
Beginning balance	81
Other comprehensive income before reclassifications	379
Gain reclassified to earnings	'
Total other comprehensive income (loss)	379
Ending Balance	460
Unrealized Gain (Loss) on Derivative Instruments [Member]	'
Accumulated Other Comprehensive Income (Loss) [Line Items]	'
Beginning balance	389
Other comprehensive income before reclassifications	3
Gain reclassified to earnings	-684
Total other comprehensive income (loss)	-681
Ending Balance	($292)

Fair_Value_Measurements_Additi

Fair Value Measurements - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2013
Fair Value Disclosures [Abstract]	'
Discount rate of fair value measurement	11.50%

Fair_Value_Measurements_Schedu

Fair Value Measurements - Schedule of Fair Value Assets and Liabilities Measured on Recurring Basis (Detail) (Fair Value, Measurements, Recurring [Member], USD $)	Sep. 30, 2013
In Thousands, unless otherwise specified
Liabilities	'
Contingent consideration liability	$576
Foreign Exchange Forward Contracts [Member]	'
Assets	'
Foreign exchange forward contracts	25
Liabilities	'
Foreign exchange forward contracts	358
Money Market Funds [Member]	'
Assets	'
Money market funds	73,778
Quoted Prices in Active Markets for Identical Assets (Level 1) [Member]	'
Liabilities	'
Contingent consideration liability	'
Quoted Prices in Active Markets for Identical Assets (Level 1) [Member] | Foreign Exchange Forward Contracts [Member]	'
Assets	'
Foreign exchange forward contracts	'
Liabilities	'
Foreign exchange forward contracts	'
Quoted Prices in Active Markets for Identical Assets (Level 1) [Member] | Money Market Funds [Member]	'
Assets	'
Money market funds	73,778
Significant Other Observable Inputs (Level 2) [Member]	'
Liabilities	'
Contingent consideration liability	'
Significant Other Observable Inputs (Level 2) [Member] | Foreign Exchange Forward Contracts [Member]	'
Assets	'
Foreign exchange forward contracts	25
Liabilities	'
Foreign exchange forward contracts	358
Significant Other Observable Inputs (Level 2) [Member] | Money Market Funds [Member]	'
Assets	'
Money market funds	'
Significant Unobservable Inputs (Level 3) [Member]	'
Liabilities	'
Contingent consideration liability	576
Significant Unobservable Inputs (Level 3) [Member] | Foreign Exchange Forward Contracts [Member]	'
Assets	'
Foreign exchange forward contracts	'
Liabilities	'
Foreign exchange forward contracts	'
Significant Unobservable Inputs (Level 3) [Member] | Money Market Funds [Member]	'
Assets	'
Money market funds	'

Supplemental_Cash_Flow_Informa2

Supplemental Cash Flow Information - Summary of Supplemental Cash Flow Information (Detail) (USD $)	9 Months Ended
In Thousands, unless otherwise specified	Sep. 30, 2013	Sep. 30, 2012
Additional Cash Flow Elements And Supplemental Cash Flow Information [Abstract]	'	'
Transfers from inventory to field equipment	$9,315	$8,183
Transfers from field equipment to deferred cost of revenues	6,012	7,279
Payment of corporate bonus in common stock	1,034	878
Market value of shares received in payment for exercise of stock options	412	513
Construction-in-process financed by construction liability	2,604	7,235
Payment of Asahi debt through the issuance of equity	'	45,219
Leasehold improvements paid by the landlord	'	4,300
Property and equipment acquired under capital lease	745	1,210
Acquisition of business	3,861	'
Deferred revenues and deferred costs related to acquiree recorded as a reduction of consideration paid	$335	'