Minerva Surgical (UTRS) 10-Q 13 Nov 23 2023 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2023	Nov. 02, 2023
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2023
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q3
Trading Symbol	UTRS
Title of 12(b) Security	Common Stock, $ 0.001 par value
Security Exchange Name	NASDAQ
Entity Registrant Name	MINERVA SURGICAL, INC.
Entity Central Index Key	0001452965
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Common Stock, Shares Outstanding		8,878,582
Entity Shell Company	false
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Incorporation, State or Country Code	DE
Entity File Number	001-40919
Entity Tax Identification Number	26-3422906
Entity Address, Address Line One	4255 Burton Dr.
Entity Address, City or Town	Santa Clara
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	95054
City Area Code	855
Local Phone Number	646-7874
Document Quarterly Report	true
Document Transition Report	false

Condensed Balance Sheets

Condensed Balance Sheets - USD ($) $ in Thousands		Sep. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents		$ 11,125	$ 6,942
Restricted cash, current		80	604
Accounts receivable, net		7,569	7,244
Inventory		18,183	16,850
Prepaid expenses and other current assets		3,045	4,479
Total current assets		40,002	36,119
Restricted cash, net of current portion		265	265
Intangible asset, net		22,326	26,778
Property and equipment, net		5,427	5,042
Operating lease right-of-use asset		3,996	270
Other non-current assets		769	426
Total assets		72,785	68,900
Current liabilities:
Accounts payable		3,036	2,804
Accrued compensation		3,577	3,701
Accrued liabilities		2,366	5,524
Current portion of operating lease liability		623	355
Current portion of long-term debt		11,649	1,894
Total current liabilities		21,251	14,278
Long-term debt		27,885	37,441
Operating lease liability, net of current portion		3,394
Total liabilities		52,530	51,719
Commitments and contingencies (Note 8)
Stockholders’ deficit:
Preferred stock, $0.001 par value, 15,000,000 and 5,000,000 shares authorized, and no shares issued and outstanding as of September 30, 2023 and December 31, 2022, respectively
Common stock, $0.001 par value, 300,000,000 and 100,000,000 shares authorized, 8,878,582 shares and 1,490,761 shares issued and outstanding as of September 30, 2023 and December 31, 2022, respectively.	[1]	9	1
Additional paid-in capital		330,953	300,837
Accumulated other comprehensive income		11	11
Accumulated deficit		(310,718)	(283,668)
Total stockholders' equity		20,255	17,181
Total liabilities and stockholders equity		$ 72,785	$ 68,900
[1] Reduction of $ 28 thousand in common stock on December 31, 2022 represents the change in issued shares as a result of the 1-for-20 reverse stock split with the offsetting change recorded in addition paid-in capital.

Condensed Balance Sheets (Paren

Condensed Balance Sheets (Parenthetical) $ in Thousands	3 Months Ended	9 Months Ended	12 Months Ended
	Sep. 30, 2023 $ / shares shares	Sep. 30, 2023 $ / shares shares	Dec. 31, 2022 USD ($) $ / shares shares
Statement of Financial Position [Abstract]
Preferred stock, par value | $ / shares	$ 0.001	$ 0.001	$ 0.001
Preferred stock, shares authorized	15,000,000	15,000,000	5,000,000
Preferred stock, shares, Issued	0	0	0
Preferred Stock, shares outstanding	0	0	0
Common stock, par value | $ / shares	$ 0.001	$ 0.001	$ 0.001
Common stock, shares authorized	300,000,000	300,000,000	100,000,000
Common stock, shares, Issued	8,878,582	8,878,582	1,490,761
Common stock, shares, outstanding	8,878,582	8,878,582	1,490,761
Reverse stock split ratio	0.05	0.05	0.05
Reduction of common stock | $			$ 28

Condensed Statements of Operati

Condensed Statements of Operations - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Statement [Abstract]
Revenues	$ 11,965	$ 12,588	$ 37,889	$ 36,490
Cost of goods sold	5,747	5,775	17,254	16,619
Gross profit	6,218	6,813	20,635	19,871
Operating expenses
Sales and marketing	6,711	9,723	26,274	28,887
General and administrative	4,190	6,142	13,770	12,706
Research and development	1,413	1,456	4,655	3,985
Total operating expenses	12,314	17,321	44,699	45,578
Loss from operations	(6,096)	(10,508)	(24,064)	(25,707)
Interest income	92	42	277	70
Interest expense	(1,172)	(861)	(3,369)	(2,196)
Other expense, net	(2)	(2)	(7)	(34)
Net loss before income taxes	(7,178)	(11,329)	(27,163)	(27,867)
Income tax expense	(3)		(42)
Net Loss	$ (7,181)	$ (11,329)	$ (27,205)	$ (27,867)
Net loss per share attributable to common stockholders, basic	$ (0.81)	$ (7.92)	$ (3.49)	$ (19.48)
Net loss per share attributable to common stockholders, diluted	$ (0.81)	$ (7.92)	$ (3.49)	$ (19.48)
Weighted-average common shares used in computing net loss per share, basic	8,872,998	1,430,056	7,805,772	1,430,272
Weighted-average common shares used in computing net loss per share, diluted	8,872,998	1,430,056	7,805,772	1,430,272

Condensed Statements of Stockho

Condensed Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Cumulative Effect Period Of Adoption Adjustment	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income	Accumulated Deficit	Accumulated Deficit Cumulative Effect Period Of Adoption Adjustment
Balance at Dec. 31, 2021	$ 44,104		$ 1	$ 293,648	$ 11	$ (249,556)
Balance, shares at Dec. 31, 2021			1,441,145
Issuance of common stock upon exercise of stock options	3			3
Issuance of common stock upon exercise of stock options, shares			258
Vesting of early exercised stock options	39			39
Stock-based compensation expense	1,523			1,523
Net loss	(10,925)					(10,925)
Balance at Mar. 31, 2022	34,744		$ 1	295,213	11	(260,481)
Balance, shares at Mar. 31, 2022			1,441,403
Balance at Dec. 31, 2021	44,104		$ 1	293,648	11	(249,556)
Balance, shares at Dec. 31, 2021			1,441,145
Net loss	(27,867)
Balance at Sep. 30, 2022	21,538		$ 1	298,949	11	(277,423)
Balance, shares at Sep. 30, 2022			1,448,422
Balance at Mar. 31, 2022	34,744		$ 1	295,213	11	(260,481)
Balance, shares at Mar. 31, 2022			1,441,403
Issuance of common stock upon exercise of stock options	18			18
Issuance of common stock upon exercise of stock options, shares			1,435
Vesting of early exercised stock options	25			25
Stock-based compensation expense	1,676			1,676
Net loss	(5,613)					(5,613)
Balance at Jun. 30, 2022	30,850		$ 1	296,932	11	(266,094)
Balance, shares at Jun. 30, 2022			1,442,838
Issuance of common stock upon release of RSUs, shares			4,438
Issuance of common stock upon exercise of stock options	13			13
Issuance of common stock upon exercise of stock options, shares			1,146
Vesting of early exercised stock options	27			27
Stock-based compensation expense	1,977			1,977
Net loss	(11,329)					(11,329)
Balance at Sep. 30, 2022	21,538		$ 1	298,949	11	(277,423)
Balance, shares at Sep. 30, 2022			1,448,422
Balance at Dec. 31, 2022	17,181	$ 155	$ 1	300,837	11	(283,668)	$ 155
Balance, shares at Dec. 31, 2022			1,490,761
Accounting Standards Update [Extensible List]		ASU 2016 -13					ASU 2016 -13
Proceeds from issuance of common stock, Share Purchase Agreement, net	26,774		$ 7	26,767
Proceeds from issuance of common stock, Share Purchase Agreement, net, shares			7,331,377
Issuance of common stock upon release of RSUs, shares			17,821
Vesting of early exercised stock options	30			30
Stock-based compensation expense	1,274			1,274
Net loss	(11,343)					(11,343)
Balance at Mar. 31, 2023	34,071		$ 8	328,908	11	(294,856)
Balance, shares at Mar. 31, 2023			8,839,959
Balance at Dec. 31, 2022	$ 17,181	$ 155	$ 1	300,837	11	(283,668)	$ 155
Balance, shares at Dec. 31, 2022			1,490,761
Issuance of common stock upon exercise of stock options, shares	1,591
Net loss	$ (27,205)
Balance at Sep. 30, 2023	20,255		$ 9	330,953	11	(310,718)
Balance, shares at Sep. 30, 2023			8,878,582
Balance at Mar. 31, 2023	34,071		$ 8	328,908	11	(294,856)
Balance, shares at Mar. 31, 2023			8,839,959
Issuance of common stock upon release of RSUs, shares			13,029
Issuance of common stock upon exercise of stock options, shares			984
ESPP purchase	79		$ 1	78
ESPP purchase, shares			23,641
Vesting of early exercised stock options	20			20
Stock-based compensation expense	1,098			1,098
Net loss	(8,681)					(8,681)
Balance at Jun. 30, 2023	26,587		$ 9	330,104	11	(303,537)
Balance, shares at Jun. 30, 2023			8,877,613
Issuance of common stock upon release of RSUs, shares			362
Issuance of common stock upon exercise of stock options, shares			607
Vesting of early exercised stock options	16			16
Stock-based compensation expense	833			833
Net loss	(7,181)					(7,181)
Balance at Sep. 30, 2023	$ 20,255		$ 9	$ 330,953	$ 11	$ (310,718)
Balance, shares at Sep. 30, 2023			8,878,582

Condensed Statements of Cash Fl

Condensed Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Cash Flows From Operating Activities:
Net loss	$ (27,205)	$ (27,867)
Adjustments to reconcile net loss to net cash used in operating activities:
Amortization of debt discount and debt issuance costs	199	186
Reserve for credit loss	92
Depreciation and amortization	5,943	8,053
Non-cash lease expense	480	465
Stock-based compensation expense	3,205	5,176
Change in fair value of contingent consideration liability		(4,094)
Loss from disposal	11	10
Net changes in operating assets and liabilities:
Accounts receivable, net	(262)	501
Inventory	(3,177)	(3,610)
Prepaid expenses and other current assets	1,346	1,874
Other non-current assets	(343)
Accounts payable	294	(807)
Accrued liabilities	(3,092)	90
Accrued compensation	(124)	706
Operating lease liability	(456)	(606)
Net cash used in operating activities	(23,089)	(19,923)
Cash Flows From Investing Activities:
Purchase of property and equipment	(105)	(125)
Net cash used in investing activities	(105)	(125)
Cash Flows From Financing Activities:
Proceeds from issuance of common stock under Share Purchase Agreement, net	26,774
Payment of contingent consideration		(5,000)
Proceeds from issuance of common stock		34
Proceeds from issuance of common stock under ESPP	79
Net cash provided by (used in) financing activities	26,853	(4,966)
Net increase (decrease) in cash, cash equivalents and restricted cash	3,659	(25,014)
Cash, cash equivalents and restricted cash at the beginning of the period	7,811	48,415
Cash, cash equivalents and restricted cash at the end of the period	11,470	23,401
Reconciliation of cash, cash equivalents and restricted cash to balance sheets
Cash and cash equivalents	11,125	15,112
Restricted cash	345	8,289
Cash, cash equivalents and restricted cash in balance sheets	11,470	23,401
Supplemental Disclosure of Cash Flow Information:
Cash paid for interest	3,141	1,930
Cash paid for income taxes	42
Supplemental Disclosure of Non-cash Items:
Vesting of early exercised stock options	66	91
Purchases of property and equipment included in accounts payable	6
Net reclassification of inventory to property and equipment for customer usage agreements	1,844	2,289
Cummulative effect adjustment from adoption of ASU 2016-13	155
Operating lease right-of-use assets obtained in exchange for operating lease liabilities	$ 4,206
Right-of-use asset acquired under operating lease on the adoption of ASC 842		$ 894

Formation and Business of the C

Formation and Business of the Company	9 Months Ended
	Sep. 30, 2023
Disclosure Text Block [Abstract]
Formation and Business of the Company	1. Formation and Business of the Company The Company Minerva Surgical, Inc. (the Company, we, us, and our) was incorporated in the state of Delaware on November 3, 2008. The Company's headquarters are in Santa Clara, California. The Company is a medical device company that develops therapeutic devices that treat abnormal uterine bleeding in a minimally invasive manner. The Company commenced commercial introduction of its products in the United States in 2015 following the clearance by the U.S. Food and Drug Administration (FDA). In May 2020, the Company acquired certain assets from Boston Scientific Corporation (BSC) to broaden its product offerings to its customers. The Company derives all of its revenue from sales to customers in the United States through a direct sales force. Private Placement On December 27, 2022, the Company entered into a Share Purchase Agreement (“Purchase Agreement”) for a private placement ( Private Placement) with Accelmed Partners II L.P. (Accelmed) and New Enterprise Associates 13, L.P. (each, a “Purchaser,” and collectively, the “Purchasers”). Pursuant to the Purchase Agreement, the Company agreed to sell to the Purchasers an aggregate of 7,331,377 shares (Shares) of the Company’s common stock , as adjusted post-reverse share split , par value $ 0.001 per share, at a purchase price of $ 4.092 per Share , as adjusted post-reverse share split , which represented a 25 % premium to the trailing five-day volume-weighted average price of the Company’s common stock on December 23, 2022. On February 9, 2023, the Private Placement closed, and the Company issued the Shares to the Purchasers, resulting in aggregate gross proceeds to the Company of $ 30.0 million before deducting placement agent fees and estimated offering expenses of $ 3.2 million. Liquidity In accordance with Financial Accounting Standard Board (FASB) Accounting Standards Codification (ASC) 205-40, Presentation of Financial Statements – Going Concern, management must evaluate whether there are conditions or events, considered in the aggregate, that raise substantial doubt about the Company’s ability to continue as a going concern within one year after the date that the financial statements are issued. This evaluation initially does not take into consideration the potential mitigating effect of management’s plans that have not been fully implemented as of the date the financial statements are issued. When substantial doubt exists under this methodology, management evaluates whether the mitigating effect of its plans sufficiently alleviates substantial doubt about the Company’s ability to continue as a going concern. The mitigating effect of management’s plans, however, is only considered if both (1) it is probable that the plans will be effectively implemented within one year after the date that the financial statements are issued and (2) it is probable that the plans, when implemented, will mitigate the relevant conditions or events that raise substantial doubt about the entity’s ability to continue as a going concern within one year after the date that the financial statements are issued. Generally, to be considered probable of being effectively implemented, the plans must have been approved before the date that the financial statements are issued. The Company’s financial statements have been prepared on a going concern basis, which contemplates the continuity of operations, realization of assets and the satisfaction of liabilities and commitments in the ordinary course of business. The Company incurred a net loss of $ 27.2 million during the nine months ended September 30, 2023 and had an accumulated deficit of $ 310.7 million as of September 30, 2023. The Company had cash and cash equivalents of $ 11.1 million as of September 30, 2023 and an outstanding long-term debt of $ 39.5 million with the Canadian Imperial Bank of Commerce (CIBC) as of September 30, 2023. The Company is actively seeking to refinance its CIBC Loan and Security Agreement (CIBC Agreement) and raise additional capital. The Company's current cash and cash equivalents will not be sufficient to fund the Company's operations within the next twelve months without additional capital. Under the current terms of the CIBC Agreement, the Company is scheduled to commence monthly repayment of the principal balance in November 2023, the end of the interest only period. As of September 30, 2023, the Company was in compliance with the financial covenants required by the CIBC Agreement. While the company is actively seeking to raise additional capital, there are inherent uncertainties with that process and should the Company be unable to raise additional funds, it is highly likely that the company will not remain in compliance with these covenants at the end of the first quarter of 2024. In the event that the Company is not in compliance with the financial covenants, the Company would be in technical default per the terms of the CIBC Agreement, with remedies available to CIBC. The presence of these conditions, individually or in the aggregate, raises substantial doubt about the Company’s ability to continue as a going concern within one year after the date that the financial statements are issued. Impact of the COVID-19 pandemic The COVID-19 pandemic and the resulting economic downturn had impacted business conditions in the industry in which the Company operates. Since March 2020, the Company’s net sales were negatively impacted by the COVID-19 pandemic as hospitals and ambulatory surgical centers (ASCs) delayed or canceled elective procedures. In response to the pandemic, many state and local governments in the U.S. issued orders that temporarily precluded elective procedures in order to conserve scarce health system resources. The decrease in hospital and ASCs admission rates and elective surgeries during the pandemic reduced both the number of patients being evaluated for treatment with and demand for elective procedures using the Company's products. During 2023, the Company has seen the impacts from COVID-19 lessening with hospitals and ASCs returning to more normal operations and supply chain disruptions becoming less frequent. The staffing impacts on hospitals may continue for some time but the level of overall elective procedures has increased. A re-occurrence of a COVID-19-like pandemic's impact on the Company is highly uncertain. Such an impact could result in a material, adverse impact on liquidity, capital resources, supply chain, operations and revenue and may affect third parties on which the Company relies.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2023
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Reverse Stock Split. At a special meeting held on February 7, 2023, the Company’s stockholders approved the Reverse Stock Split with a ratio within a range of between 1-for-5 and 1-for-25 , with the exact ratio to be set at the discretion of the Company’s Board of Directors. On September 19, 2023, the Board of Directors approved a ratio of 1-for-20 for the reverse stock split (Reverse Stock Split), which became effective on September 29, 2023 . As of the effective date, every twenty issued and outstanding shares of common stock was converted into one share of common stock, The common stock began trading on a reverse split-adjusted basis on the Nasdaq at the opening of trading on October 2, 2023. All issued and outstanding common stock and per share amounts contained in the financial statements have been retroactively adjusted to reflect this Reverse Stock Split for all periods presented. In addition, a proportionate adjustment was made to the per share exercise price and the number of shares issuable upon the exercise and/or vesting of all outstanding stock options, restricted stock units and warrants to purchase shares of common stock. A proportionate adjustment was also made to the number of shares reserved for issuance pursuant to the Company’s equity incentive compensation plans to reflect the Reverse Stock Split. No fractional shares of common stock were issued as a result of the Reverse Stock Split. Par value of common stock and preferred stock remained unchanged. The common stock par value and additional paid-in-capital line items contained in the financial statements were adjusted to account for the Reverse Stock Split for all periods presented. The Reverse Stock Split affected all stockholders uniformly and did not alter any stockholder's percentage interest in the Company's equity. Basis of presentation The accompanying financial statements have been prepared using accounting principles generally accepted in the United States of America (GAAP). Certain prior year amounts have been reclassified to conform to the current year presentation. Unaudited interim financial information The accompanying condensed balance sheet as of September 30, 2023, the condensed statements of operations, the condensed statements of stockholders’ equity and condensed statements of cash flows for the periods ended September 30, 2023 and 2022 are unaudited. The unaudited interim condensed financial statements have been prepared on the same basis as the 2022 audited annual financial statements and, in the opinion of management, reflect all adjustments, which include normal recurring adjustments, necessary for the fair statement of the Company’s financial position as of September 30, 2023 and the results of its operations for the three- and nine-month periods ended September 30, 2023 and 2022, and its cash flows for the nine-month periods ended September 30, 2023 and 2022. The financial data and other information disclosed in these notes related to the three- and nine-month periods ended September 30, 2023 and 2022 are also unaudited. The results for the three- and nine-month periods ended September 30, 2023 are not necessarily indicative of results to be expected for the year ending December 31, 2023, any other interim periods, or any future year or period. The balance sheet as of December 31, 2022 included herein was derived from the audited financial statements as of that date. Certain disclosures have been condensed or omitted from the interim condensed financial statements. These unaudited interim condensed financial statements should be read in conjunction with the audited annual financial statements and related notes. The significant accounting policies used in the preparation of the unaudited condensed financial statements for the three- and nine-month periods ended September 30, 2023 and 2022, are consistent with those discussed in Note 2 to the audited financial statements and notes thereto for the year ended December 31, 2022, included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022 filed with the Securities and Exchange Commission (SEC) on March 22, 2023. There have been no significant changes in the significant accounting policies or critical accounting estimates since December 31, 2022, except for the accounting policy related to FASB Accounting Standards Update (ASU) 2016-13, Financial Instruments-Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments discussed below. Use of estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the 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 periods. Although these estimates are based on the Company’s knowledge of current events and actions it may undertake in the future, actual results may ultimately materially differ from these estimates and assumptions. Significant estimates and assumptions include accounts receivable allowances, inventory allowances, recoverability of long-term assets including definite-lived intangible assets, revaluation of equity instruments and equity-linked instruments, stock-based compensation, contingent consideration liability, deferred tax assets and related valuation allowances, impact of contingencies and the Company’s incremental borrowing rate used to calculate lease assets . Change in accounting estimate In accordance with our policy, the Company reviews the estimated useful lives of its fixed assets on an ongoing basis. This review, which included a study of historic replacement requirements, indicated that the actual lives of equipment under customer usage agreements were longer than the estimated useful lives used for depreciation purposes. As a result, effective January 1, 2023, the Company changed its estimate of the useful lives of equipment under customer usage agreements from three to five years . The effect of this change in estimate was to reduce depreciation expense by $ 0.3 million and $ 0.8 million, decrease net loss by $ 0.3 million and $ 0.8 million, and decrease basic and diluted loss per share by an immaterial amount, for the three and nine months ended September 30, 2023, respectively. Fair value of financial instruments The carrying amounts of the Company’s financial instruments, including cash and cash equivalents, accounts receivable and accounts payable, approximate their fair value due to the short-term nature of these assets and liabilities. Based on the borrowing rates currently available to the Company for debt with similar terms and consideration of default and credit risk, the carrying value of the term loan approximates its fair value and is classified as a Level 2 liability. Concentration of credit risk Financial instruments that potentially subject the Company to concentrations of risk consist principally of cash, cash equivalents and accounts receivable. The Company maintains its cash and cash equivalents balances with established financial institutions and, at times, such balances with any one financial institution may be in excess of the Federal Deposit Insurance Corporation (FDIC) insured limits. The Company maintains long-term debt with a variable interest rate that resets monthly and has been subject to the recent inflationary rise in interest rates during the past year. Additionally, the Company is subject to interest rate risk when its long-term loan become due and in the event of a refinancing. The Company earns revenue from sale of disposable devices and controllers to customers such as hospitals, ambulatory surgical centers and physician offices. The Company’s accounts receivable are derived from revenue earned from customers. The Company performs ongoing credit evaluations of its customers’ financial condition and generally requires no collateral from its customers. At September 30, 2023 and 2022, and for the periods then ended, no customer accounted for more than 10.0% of accounts receivable or revenue. Concentration of suppliers The Company purchases certain components of its products from a single or small number of suppliers. A change in or loss of these suppliers could cause a delay in filling customer orders and a possible loss of sales, which could adversely affect our results of operations; however, management believes that suitable replacement suppliers could be obtained in such an event. Accounts Receivable and Estimated Credit Losses The Company adopted ASU 2016-13, Financial Instruments-Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments , effective January 1, 2023 using the modified retrospective method. The adoption of this standard did not have a material cumulative effect on opening accumulated deficit as of January 1, 2023 and did not have a material impact on the Company’s financial statements for the three and nine months ended September 30, 2023. As of January 1, 2023, accounts receivable are recorded at invoice value, net of the Company's reserve for estimated credit losses. The Company applies its loss-rate method to measure its estimated credit loss for receivables using its historical collection experience, current and ongoing evaluation of customer balances including transaction history, aging status and financial condition of its customers, plus reasonable and supportable forecast of future economic market conditions. Specific credit loss reserve amounts are established to record the appropriate reserve for the Company's current estimate of credit losses (CECL) reserves for its pool of identified customers that have an identified risk of default. A general credit loss reserve is then established based upon the Company’s assessment of estimated credit losses for its remaining receivables pool based on its loss-rate method. Balances are written-off when they are ultimately determined to be uncollectible. The following table summarizes th e year-to-date activity in the reserve for credit loss account (in thousands): January 1, 2023 $ 542 Amounts charged to costs and expenses 92 Write-offs ( 40 ) September 30, 2023 $ 594 Advertising costs Expenses related to advertising of produ cts are charged to sales and marketing expense as incurred. During the three and nine months ended September 30, 2023, the Company incurred none and $ 0.1 million, respectively, in advertising expenses. During the three and nine months ended September 30, 2022, the Company incurred $ 0.2 million and $ 0.4 million, respectively, in advertising expenses. Net loss per share Basic net loss per share is calculated by dividing the net loss by the weighted-average number of common shares outstanding during the period, without consideration for potentially dilutive securities. Diluted net loss per share is computed by dividing the net loss by the weighted-average number of common shares and potentially dilutive securities outstanding for the period. For purposes of the diluted net loss per share calculation, redeemable convertible preferred stock warrants, convertible notes, common stock subject to repurchase, restricted stock units and common stock options are considered to be potentially dilutive securities. Basic and diluted net loss per share is presented. The Company also considers the shares issued upon the early exercise of stock options subject to repurchase to be participating securities, because holders of such shares have non-forfeitable dividend rights in the event a dividend is paid on common stock. Because the Company has reported a net loss for the three- and nine-month periods ended September 30, 2023 and 2022, diluted net loss per common share is the same as basic net loss per common share for all periods presented.

Recent Accounting Pronouncement

Recent Accounting Pronouncements	9 Months Ended
	Sep. 30, 2023
Accounting Standards Update and Change in Accounting Principle [Abstract]
Recent Accounting Pronouncements	3. Recent Accounting Pronouncements Recently Adopted Accounting Pronouncements In July 2023, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) 2023-03, “Presentation of Financial Statements (Topic 205), Income Statement - Reporting Comprehensive Income (Topic 220), Distinguishing Liabilities from Equity (Topic 480), Equity (Topic 505), and Compensation - Stock Compensation (Topic 718) : A mendments to SEC Paragraphs Pursuant to SEC Staff Accounting Bulletin No. 120, SEC Staff Announcement at the March 24, 2022 EITF Meeting, and Staff Accounting Bulletin Topic 6.B, Accounting Series Release 280 - General Revision of Regulation S-X: Income or Loss Applicable to Common Stock” (ASU 2023-03). This ASU amends various paragraphs in the accounting codification pursuant to the issuance of Commission Staff Bulletin (SAB) No. 120. ASU 2023-03 does not provide any new guidance, so there is no transition or effective date. ASU 2023-03 did not have a material impact on our condensed financial statements. The Company adopted ASU 2016-03, Financial Instruments - Credit Losses: Measurement of Credit Losses on Financial Instruments (ASU 2016-13) effective Ja nuary 1, 2023 , using the modified retrospective approach with a cumulative effect adjustment to the accumulated deficit at the beginning of the period of adoption . Upon adoption of ASU 2016-13 , the Company derecognized its allowance for doubtful accounts of $ 0.7 million, recognized a CECL reserve of $ 0.5 million with a net adjustment to retained earnings of $ 0.2 million as of January 1, 2023 with no resulting impact to the condensed statements of operations or condensed statements of cash flows. Accounting Standards Not Yet Adopted There were no other new accounting pronouncements, issued or effective during the first nine months of fiscal 2023, which had or are expected to have a significant impact on the Company’s consolidated financial statements.

Revenue

Revenue	9 Months Ended
	Sep. 30, 2023
Revenue from Contract with Customer [Abstract]
Revenue	4. Revenue Disaggregation of revenue For the Three Months Ended September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Minerva ES 43.7 % 46.8 % 45.0 % 45.1 % Genesys HTA 25.2 % 28.4 % 26.6 % 29.5 % Symphion 30.1 % 24.1 % 27.4 % 24.8 % Other 1.0 % 0.7 % 1.0 % 0.6 % 100 % 100 % 100 % 100 % For the three months ended September 30, 2023 and 20 22, 99.9 % of the Company’s revenue is subject to point-in-time recognition for single-use (disposable) products and capital equipment across all revenue streams. Sale of extended warranties on capital equipment within other revenue represents less than 0.1 % of the Company’s revenue for the three-month periods ended on September 30, 2023 and 2022. In addition, for the three months ended September 30, 2023 and 2022, 98.7 % and 97.0 % of the Company’s total revenue is derived from the sale of single-use (disposable) products; therefore, the Company did not include disaggregated revenue data to present the amounts attributed to capital equipment, associated warranties, and miscellaneous revenue separately. For the nine months ended September 30, 2023 and 2022, 99.9 % of the Company’s revenue is subject to point-in-time recognition for single-use (disposable) products and capital equipment across all revenue streams. Sale of extended warranties on capital equipment within other revenue represents less than 0.1 % of the Company’s revenue for the nine-month periods ended on September 30, 2023 and 2022. In addition, for the nine months ended September 30, 2023 and 2022, 98.5 % and 98.0 % of the Company’s total revenue is derived from the sale of single-use (disposable) products; therefore, the Company did not include disaggregated revenue data to present the amounts attributed to capital equipment, associated warranties, and miscellaneous revenue separately. Contract balances The Company’s contract balances consist of the following (in tho usands): September 30, December 31, 2023 2022 Accounts receivable, net $ 7,569 $ 7,244 Contract liability—current (see Note 6) $ 202 $ 339

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2023
Fair Value Disclosures [Abstract]
Fair value measurements	5. Fair value measurements ASC 820, Fair Value Measurements and Disclosures, 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. ASC 820 establishes a fair value hierarchy that distinguishes between (1) market participant assumptions developed based on market data obtained from independent sources (observable inputs) and (2) an entity’s own assumptions about market participant assumptions developed based on the best information available in the circumstances (unobservable inputs). The fair value hierarchy consists of three levels, which gives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level 1) and the lowest priority to unobservable inputs (Level 3). The three levels of the fair value hierarchy under ASC 820 are described below: Level 1—Inputs are unadjusted quoted prices in active markets for identical assets or liabilities that the Company has the ability to access as of the measurement date. Level 2—Inputs are observable, unadjusted quoted prices in active markets for similar assets or liabilities, unadjusted quoted prices for identical or similar assets or liabilities in markets that are not active or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the related assets or liabilities. Level 3—Unobservable inputs for the asset or liability only used when there is little, if any, market activity for the asset or liability at the measurement date. This hierarchy requires the Company to use observable market data, when available, and to minimize the use of unobservable inputs when determining fair value. Assets and Liabilities Measured and Recorded at Fair Value on a Recurring Basis —Financial assets held by the Company measured at fair value on a recurring basis include money market funds which are classified as Level 1 within the fair value hierarchy as the inputs used to measure fair value are quoted prices in active markets for identical assets. Assets and liabilities measured at fair value are classified in their entirety based on the lowest level of input that is significant to the fair value measurement. The Company’s assessment of the significance of a particular input to the fair value measurement in its entirety requires management to make judgments and consider factors specific to the asset or liability. Fair value of assets and liabilities The following tables summarize the type s of assets and liabilities measured at fair value on a recurring basis by level within the fair value hierarchy (in thousands): September 30, 2023 Level 1 Level 2 Level 3 Total Assets: Cash equivalents: Money market funds $ 9,077 $ — $ — $ 9,077 Total financial assets $ 9,077 $ — $ — $ 9,077 December 31, 2022 Level 1 Level 2 Level 3 Total Assets: Cash equivalents: Money market funds $ 3,149 $ — $ — $ 3,149 Total financial assets $ 3,149 $ — $ — $ 3,149 The change in fair value of the contingent consideration liability du e to BSC is summarized below (in thousands): Contingent Fair value, December 31, 2021 $ 14,094 Change in fair value ( 151 ) Payment ( 5,000 ) Ending fair value, March 31, 2022 8,943 Change in fair value ( 3,943 ) Fair value, June 30, 2022 5,000 Change in fair value - Fair value, September 30, 2022 $ 5,000 As of December 31, 2022, the contingent consideration liability due to BSC for the potential future milestone payment was resolved and a liability was no longer recorded.

Balance Sheet Components

Balance Sheet Components	9 Months Ended
	Sep. 30, 2023
Balance Sheet Components [Abstract]
Balance Sheet Components	6. Balance Sheet Components Cash and cash equivalents The Company’s cash and cash equivalents cons ist of the following (in thousands): September 30, December 31, 2023 2022 Cash $ 2,048 $ 3,793 Cash equivalents: Money market funds 9,077 3,149 Total cash and cash equivalents $ 11,125 $ 6,942 Inventory Inventory co nsists of the following (in thousands): September 30, December 31, 2023 2022 Finished goods $ 8,845 $ 7,142 Component materials 9,338 9,708 Total inventory $ 18,183 $ 16,850 Prepaid expenses and other current assets Prepaid expenses and other current assets consis t of the following (in thousands): September 30, December 31, 2023 2022 Prepaid expenses $ 2,402 $ 2,164 Prepaid insurance 326 1,560 Other current assets 317 755 Total prepaid expenses and other current assets $ 3,045 $ 4,479 Property and equipment, net Property and equipment, net consist of the following (in thousands): September 30, December 31, Useful life (years) 2023 2022 Computers and software 2 $ 359 $ 343 Machinery and equipment 3 666 664 Furniture and fixtures 7 48 48 Tools and dies 2 906 900 Construction in progress — 94 131 Equipment under customer usage agreements 5 14,278 13,226 Leasehold improvements Lesser of useful life or lease term 155 155 16,506 15,467 Less: accumulated depreciation and amortization ( 11,079 ) ( 10,425 ) Property and equipment, net $ 5,427 $ 5,042 Depreciation and amortization expe nse on property and equipment was $ 0.5 million and $ 0.6 million for the three-month periods ended on September 30, 2023 and 2022, respectively. Of this amount $ 0.5 million and $ 0.6 million for the three-month periods ended on September 30, 2023 and 2022, respectively, was related to equipment under customer usage agreements recorded to cost of goods sold, which reflects a change in estimate of $ 0.3 million reducing depreciation expense recognized during the three-month period ended September 30, 2023. See Note 2 for further information. Depreciation and amortization expense on property and equipment was $ 1.5 million and $ 1.9 million for the nine-month periods ended on September 30, 2023 and 2022, respectively. Of this amount $ 1.3 million and $ 1.7 million for the nine-month periods ended on September 30, 2023 and 2022, respectively, was related to equipment under customer usage agreements recorded to cost of goods sold, which reflects a change in estimate of $ 0.8 million reducing depreciation expense recognized during the nine-month period ended September 30, 2023. See Note 2 for further information. Intangible assets, net Intangible assets, net consist of the following (in thousands): September 30, 2023 Remaining life (years) Gross Carrying Value Accumulated Amortization Net Carrying Value Trademarks 3.2 $ 3,969 $ ( 2,061 ) $ 1,908 Developed technology 6.7 30,819 ( 10,401 ) 20,418 Customer relationships — 13,466 ( 13,466 ) — Total intangible assets $ 48,254 $ ( 25,928 ) $ 22,326 December 31, 2022 Remaining life (years) Gross Carrying Value Accumulated Amortization Net Carrying Value Trademarks 3.9 $ 3,969 $ ( 1,603 ) $ 2,366 Developed technology 7.4 30,819 ( 8,090 ) 22,729 Customer relationships 0.4 13,466 ( 11,783 ) 1,683 Total intangible assets $ 48,254 $ ( 21,476 ) $ 26,778 Amortization expense on intangible assets was $ 0.9 million and $ 2.0 million for the three-month periods ended on September 30, 2023 and 2022. Amortization expense on intangible assets was $ 4.5 million and $ 6.1 million for the nine-month periods ended on September 30, 2023 and 2022, respectively. Future amortization expense of intangible assets related to the acquisition of assets from BSC as of September 30, 2023 is as follows (in thousands): 2023 (remaining three months) $ 923 2024 3,693 2025 3,693 2026 3,614 2027 3,082 Thereafter 7,321 Total $ 22,326 Accrued compensation Accrued compensation co nsists of the following (in thousands): September 30, December 31, 2023 2022 Accrued vacation $ 1,391 $ 1,559 Accrued bonuses 1,745 1,248 Accrued commissions 337 730 Other accrued personnel related expenses 104 164 Total accrued compensation $ 3,577 $ 3,701 Accrued liabilities Accrued liabilities consist of the following (in th ousands): September 30, December 31, 2023 2022 Accrual for litigation $ — $ 2,000 Accrued professional fees 240 643 Accrued sales and use taxes 121 271 Accrual for inventory in transit 475 663 Contract liability 202 339 Accrued interest expense 350 321 Others 978 1,287 Total accrued liabilities $ 2,366 $ 5,524 Commencing in 2023, the Company classifies invoiced inventory in transit up into accounts payable. As of September 30, 2023 , inventory in transit of $ 0.2 million had been i nvoiced and recognized into accounts payable.

Debt

Debt	9 Months Ended
	Sep. 30, 2023
Debt Disclosure [Abstract]
Debt	7. Debt CIBC term loan On October 8, 2021, the CIBC and the Company entered into the CIBC Agreement, which provides for a senior secured term loan in an aggregate principal amount of $ 40.0 million (CIBC Loan), the full amount of which was funded at the closing of the CIBC Agreement. The CIBC Agreement provides for 24 months of interest-only payments followed by 36 equal monthly payments of principal, plus accrued and unpaid interest, with the final obligations due and payable in full on October 8, 2026. The CIBC Loan accrues interest at a floating rate equal to 2.5 % above th e prime rate, and the interest is payable monthly in arrears. As of September 30, 2023 , the CIBC Loan had an annual effective interest rate of 12.5 % per annum. The Company may prepay the CIBC Loan in whole or in parts. Obligations under the CIBC Agreement are secured by substantially all of the Company’s assets. The CIBC Agreement contains customary affirmative and negative covenants as well as financial covenants that require the Company to maintain minimum revenue and minimum cash thresholds. The CIBC Agreement contains customary events of default subject to customary cure periods for certain defaults that include, among others, non-payment defaults, inaccuracy of representations and warranties, covenant defaults, cross-defaults to certain other material indebtedness, bankruptcy, and insolvency events with respect to the Company, and material judgments. Upon the occurrence and during the continuance of an event of default, CIBC may accelerate the Company’s obligations under the CIBC Agreement, increase the applicable interest rate by 5.0 % and exercise other remedies provided for under the CIBC Agreement and applicable law. The CIBC Loan consists of the following (in t housands): September 30, December 31, 2023 2022 Term loan principal $ 40,000 $ 40,000 Less: Debt discount and debt issuance cost ( 466 ) ( 665 ) Accrued interest payable 350 321 Term loan $ 39,884 $ 39,656 The Company paid $ 1.0 million in fees to CIBC and third parties which is reflected as a debt discount and debt issuance costs, respectively, and are being accreted over the life of the term loan using the effective interest method. During the three-month periods ended September 30, 2023 and 2022, the Company reco rded interest expense of $ 1.2 million and $ 0.9 million, which include interest expense related to accretion of debt discount and debt issuance costs of the CIBC Loan of $ 0.1 million, respectively. During the nine-month periods ended September 30, 2023 and 2022, the Company recorded interest expense of $ 3.4 million and $ 2.2 million, which include interest expense related to accretion of debt discount and debt issuance costs of the CIBC Loan of $ 0.2 million and $ 0.2 million, respectively. Contractual maturities of financing obligations As of September 30, 2023, the aggregate future payments under the CIBC Loan (including interest payments) are as follows (in thousands): 2023 (remaining three months) $ 3,599 2024 16,482 2025 15,053 2026 12,537 Total 47,671 Less: unamortized debt discounts and issuance costs ( 466 ) Less: interest ( 7,671 ) Long-term debt $ 39,534

Operating Lease

Operating Lease	9 Months Ended
	Sep. 30, 2023
Leases [Abstract]
Operating Lease	8. Operating Lease The Company's corporate headquarters, research and development facilities, manufacturing and distribution center are located in Santa Clara, CA (Santa Clara facility) and had been subject to a non-cancellable operating sublease that terminated on May 31, 2023 and is now subject to a new operating lease arrangement (Mission Park Lease). The new lease commenced on June 1, 2023 and will expire on May 31, 2028 and contains monthly base rent payments of approximately $ 88,341 that increase annually by 3 % over the term of the lease. In addition to the base rent, the Company will reimburse the landlord for certain operating expenses under the terms of the new lease. The Company established a letter of credit for $ 0.3 million as collateral for the Mission Park Lease in favor of the new lessor and it is recorded as restricted cash on the balance sheet. The Company recognized rent expense on the Santa Clara facility of $ 0.3 million and $ 0.7 million for the three and nine months ended on September 30, 2023 , and $ 0.2 million and $ 0.5 million for the three and nine months ended on September 30, 2022. The Company adopted ASC 842 and the related amendments on January 1, 2022 . The following table contains a summary of the lease costs recognized under ASC 842 and other information pertaining to the Company’s operating leases for the three- and nine-month periods ended September 30, 2023 and 2022 : For Three Months Ended September 30, For Nine Months Ended September 30, 2023 2022 2023 2022 Lease Cost Operating lease cost $ 281 $ 163 $ 647 $ 490 Variable lease cost 40 38 203 186 Total lease cost $ 321 $ 201 $ 850 $ 676 Other Information Operating cash flows used for lease liabilities $ 265 $ 214 $ 709 $ 631 Right of use asset acquired under operating lease on the adoption of ASC 842 $ - $ - $ - $ 894 Right-of-use assets obtained in exchange for new operating lease liabilities $ - $ - $ 4,206 $ - Remaining lease terms and discount rates for our facility lease as of September 30, 2023 and December 31, 2022 were as follows: September 30, December 31, 2023 2022 Incremental borrowing rate 12.25 % 4.00 % Remaining lease term (in years) 4.7 0.4 As of September 30, 2023 , operating lease right of use assets were $ 4.0 million and operating lease liabilities were $ 4.0 million. The Company has no finance leases. The future minimum lease payments under all non-cancelable operating lease obligations as of September 30, 2023 were as follows (in thousands): September 30, 2023 2023 (remaining three months) $ 353 2024 1,081 2025 1,114 2026 1,147 2027 1,182 Thereafter 398 Total undiscounted lease payments 5,275 Less: imputed interest ( 1,258 ) Total operating lease liability 4,017 Less: current portion of operating lease liability 623 Operating lease liability, net of current portion $ 3,394 The Company had maintained letters of credit of $ 0.5 million in connection with the Company’s expired lease which were released during the third quarter of 2023. The Company maintains letters of credit of $ 0.3 million in connection with the Company’s Mission Park Lease. As of September 30, 2023 and December 31, 2022, the cash amount associated with the facilities leases w as recorded as restricted cash on the condensed balance sheet.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	9. Commitments and Contingencies Indemnification The Company enters into indemnification provisions under its agreements with other companies in the ordinary course of business, including business partners and contractors. Pursuant to these arrangements, the Company indemnifies, holds harmless, and agrees to reimburse the indemnified parties for losses suffered or incurred by the indemnified party as a result of the Company’s activities. The terms of these indemnification agreements are generally perpetual. The maximum potential amount of future payments the Company could be required to make under these agreements is not determinable. The Company has never incurred costs to defend lawsuits or settle claims related to these indemnification agreements. As a result, the Company believes the estimated fair value of these agreements is minimal. The Company maintains commercial general liability insurance and products liability insurance to offset certain of its potential liabilities under these indemnification provisions. Litigation The Company regularly evaluates its exposure to threatened or pending litigation and other business contingencies. Because of the uncertainties related to the amount of loss from litigation and other business contingencies, the recording of losses relating to such exposures requires significant judgment about the potential range of outcomes. As additional information about current or future litigation or other contingencies becomes available, the Company will assess whether such information warrants the recording of additional expense. Minerva-Hologic Related Legal Actions For more information related to litigation between Hologic, Inc. (Hologic) and the Company, see Note 8 – Commitments and Contingencies - Litigation to the Notes to Financial Statements included in Item 8 to the Company’s Annual Report on Form 10-K for the period ended December 31, 2022. During the second quarter of 2023, the Company entered into a settlement agreement resolving all claims, and all related litigation has been dismissed.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2023
Income Tax Disclosure [Abstract]
Income Taxes	10. Income Taxes The Company recorded an income tax provision of $ 3 thousand and $ 42 thousand for the three and nine month periods ended September 30, 2023 , respectively. The Company recorded a $ nil income tax provision for the three and nine month periods ended September 30, 2022. The Company’s net deferred tax assets are fully offset by a valuation allowance, as the Company believes it is more likely than not the benefit will not be realized.

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2023
Equity [Abstract]
Stockholders' Equity	11. Stockholders’ Equity Preferred stock The Amended and Restated Certificate of Incorporation authorizes the Company to issue up to 15,000,000 shares of $ 0.001 par value preferred stock. Common stock The Amended and Restated Certificate of Incorporation authorizes the Company to issue up to 300,000,000 shares of $ 0.001 par value common stock. Private Placement On December 27, 2022, the Company entered into a Purchase Agreement and agreed to sell an aggregate of 7,331,377 shares of the Company’s common stock , as adjusted post-reverse share split,. On February 9, 2023, the Private Placement closed and the Company issued the shares. Common stock warrants As of September 30, 2023, the Company`s outstanding warrants to purchase shares of common stock consisted of the following: Issuance Date Number of Shares of Common Stock Issuable Exercise Price Classification Expiration Date May 9, 2017 1,696 $ $ 226.20 Equity May 8, 2027 July 19, 2019 2,192 $ $ 226.20 Equity July 18, 2029 3,888 Shares reserved for future issuance The Company has shares of common stock reserved for future issuances as follows: September 30, December 31, 2023 2022 Warrants to purchase common stock 3,888 3,888 Common stock options issued and outstanding 1,310,122 114,530 Common stock available for future grants 724,243 18,705 Restricted stock units issued and outstanding 24,782 62,353 Common stock available for ESPP 173,470 3 2008 Stock Plan and 2021 Equity Incentive Plan, as amended A summar y of stock option activity is set forth below (in thousands, except share and per share data): Number of Weighted Weighted Aggregate Outstanding, December 31, 2022 114,357 $ 166.72 8.0 $ 1 Options granted 1,271,964 $ 5.58 Options exercised ( 1,591 ) $ 6.53 Options forfeited or cancelled or expired ( 74,608 ) $ 48.96 Outstanding, September 30, 2023 1,310,122 $ 9.2 $ - Shares exercisable September 30, 2023 182,188 $ 79.83 7.9 $ - Vested and expected to vest, September 30, 2023 1,310,122 $ 17.18 9.2 $ - The aggregate intrinsic value is calculated as the difference between the exercise price of the underlying stock options and the fair value of the Company’s common stock for stock options that were in-the-money as of September 30, 2023 and December 31, 2022. The aggregate intrinsic value of stock options exercised during the three and nine months ended September 30, 2023 and 2022 was de minimis. The total fair value of options that vested during the nine months ended September 30, 2023 and 2022 was $ 2.6 million and $ 2.9 million, respectively. The options granted during the nine months ended September 30, 2023 and 2022 had a weighted-average per share grant-date fair value of $ 3.96 per share and $ 42.29 per share, respectively. As of September 30, 2023 , the total unrecognized stock-based compensation expense related to unvested stock options was $ 6.3 million, which is expected to be recognized over the remaining weighted-average vesting period of 3.1 years. Early exercise of stock options The terms of the 2008 Plan permit the exercise of certain options granted under the 2008 Stock Plan prior to vesting, subject to required approvals. The shares are subject to the Company’s lapsing repurchase right upon termination of employment at the original purchase price. The proceeds initially are recorded in accrued current liabilities from the early exercise of stock options and are reclassified to additional paid-in capital as the Company’s repurchase right lapses. During the three and nine months ended September 30, 2023 and 2022, the Company had no repurchases of common stock. As of September 30, 2023 and December 31, 2022, there were 4,761 shares and 9,401 shares that were subject to repurchase, respectively. The aggregate exercise prices of early exercised shares as of September 30, 2023 and December 31, 2022 were $ 0.1 million and $ 0.1 million, respectively, which were recorded in other current liabilities on the condensed balance sheets. Restricted Stock Units (RSU) A summary of RSU activity is set forth below: During third quarter 2023, no RSU were granted under 2021 Plan. As of September 30, 2023 , the total unrecognized stock-based compensation expense related to unvested RSU was $ 1.1 million, which is expected to be recognized over the remaining weighted-average vesting period of 2.5 years. Number of Weighted Average Grant Date Fair Value Unvested, December 31, 2022 62,340 $ 51.65 Released ( 31,212 ) $ 51.41 Forfeited or cancelled ( 6,346 ) $ 52.17 Unvested, September 30, 2023 24,782 $ 51.83 2021 Employee Stock Purchase Plan, as amended (ESPP) The fair value of the predicted share purchase rights granted under the ESPP upon the commencement of the offering period was estimated on the date of grant using the Black-Scholes option pricing model. For the offering period commenced December 1, 2022, the Company applied the following assumptions: (i) risk- free interest rate 4.61 %, (ii) dividend rate 0 %, (iii) expected terms 0.5 year and 1.0 year, and (iv) volatility 77.21 % and 76.29 %, for the two tranches, respectively. For the offering period commenced June 1, 2023, the Company applied the following assumptions: (i) risk- free interest rate 4.61 %, (ii) dividend rate 0 %, (iii) expected terms 0.5 year and 1.0 year, and (iv) volatility 77.21 % and 76.29 %, for the two tranches, res pectively. Compensation expe nse of less than $ 0.1 million wa s recorded into the condensed statement of operations for the three and nine months ended September 30, 2023. Compensation expe nse of $ 0.1 million and $ 0.2 million wa s recorded into the condensed statement of operations for the three and nine months ended September 30, 2022. As of September 30, 2023, the total unrecognized compensation cost related to the ESPP tranches was immaterial, which will be amortized for the two offerings over weighted-average period of 0.3 years. Stock-based compensation associated with awards to employees and non-employees Total stock-based compensation expense recognized was as follows (in thous ands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Cost of goods sold $ 27 $ 97 $ 109 $ 240 Sales and marketing 258 729 1,229 1,918 Research and development 5 4 21 33 General and administrative 543 1,147 1,846 2,985 Total $ 833 $ 1,977 $ 3,205 $ 5,176 The above stock-based compensation expense related to the following equity-based awards (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Stock options $ 674 $ 954 $ 2,459 $ 2,969 RSU 154 852 706 1,982 ESPP 5 171 40 225 Total $ 833 $ 1,977 $ 3,205 $ 5,176 The Company estimated the fair value of stock options using the Black-Scholes option-pricing model. The fair value of stock options is being amortized on a straight-line b asis over the requisite service period of the awards. The fair value of stock options was estimated using the following weighted-average assumptions: Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Expected dividends 0 % 0 % 0 % 0 % Expected volatility 78.10 % 72.2 % 77.4 %- 78.1 % 70.8 %- 72.2 % Risk-free interest rate 4.0 % 2.8 % 4.2 % 1.9 %- 3.0 % Expected term 6 years 6 years 6 years 6 years

Net Loss Per Share Attributable

Net Loss Per Share Attributable To Common Stockholders	9 Months Ended
	Sep. 30, 2023
Earnings Per Share [Abstract]
Net Loss Per Share Attributable to Common Stockholders	12. Net Loss Per Share Attributable To Common Stockholders In the third quarter of 2023, the Company announced that it would proceed with the 1-for-20 reverse stock split, as approved by shareholders, and filed an amendment to its certificate of incorporation to effectuate the reverse stock split after the close of trading on September 29, 2023. The Company's common stock began trading on an adjusted basis on October 2, 2023. Effective this quarter, our shares of outstanding common stock and earnings per share calculation and potentially dilutive securities have been retroactively restated for all periods presented. Th e following table sets forth the computation of basic and diluted net loss per share attributable to common stockholders which is computed by dividing the net loss by the weighted-average number of common stock outstanding for the period. For the Three Months Ended September 30, For the Nine Months Ended September 30, (in thousands, except share and per share amounts) 2023 2022 2023 2022 Numerator Net loss attributable to common stockholders $ ( 7,181 ) $ ( 11,329 ) $ ( 27,205 ) $ ( 27,867 ) Denominator: Weighted-average common stock outstanding 8,872,998 1,430,056 7,805,772 1,430,272 Net loss per share attributable to common stockholders, basic and diluted $ ( 0.81 ) $ ( 7.92 ) $ ( 3.49 ) $ ( 19.48 ) The following table indicates the number of potentially dilutive securities excluded from the calculation of Diluted net income (loss) per common share because their inclusion would have been anti-dilutive. The number of shares is as of the end of each period: September 30, 2023 2022 Common stock warrants 3,888 3,888 Unvested early exercised common stock options 4,761 13,875 Options to purchase common stock 1,310,322 109,166 Unvested restricted stock units 24,782 85,161

Employee Benefit Plan

Employee Benefit Plan	9 Months Ended
	Sep. 30, 2023
Disclosure Text Block Supplement [Abstract]
Employee Benefit Plan	13. Employee Benefit Plan In 2012, the Company implemented a tax deferred savings plan, commonly referred to as a 401(k) plan. Employee contributions are withheld from standard payroll checks and are automatically withdrawn from the Company checking account and deposited into individual employee retirement accounts a few days following each payroll period. There has been no Company matching of employee contributions to the plan through September 30, 2023 .

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2023
Subsequent Events [Abstract]
Subsequent Events	14. Subsequent Events Share Purchase Agreement On September 28, 2023, the Company entered into a Share Purchase Agreement as part of a private placement (New Private Placement) with Accelmed Partners II LP, (New Purchaser), the Company’s largest stockholder. Pursuant to the New Purchase Agreement, the Company agreed to sell to the New Purchaser 7,331,377 shares (New Shares) of the Company’s common stock, as adjusted post-reverse split, par value $ 0.001 per share (Common Stock), at a purchase price of $ 4.092 per New Share, as adjusted post-reverse split, the same price per share previously paid by Purchaser in February 2023. The number of New Shares to be sold and the price per New Share were subject to adjustment for any stock splits or similar events that occur prior to closing, including the Reverse Stock Split described in Note 1. The New Private Placement was being undertaken in order to satisfy a condition to a potential refinancing that requires the Company to complete an equity financing of at least $ 20.0 million. The closing of the New Private Placem ent was to occur on or before November 1, 2023, subject to the satisfaction of the closing conditions. Since closing of the New Private Placement did not take place on or before November 1, 2023, the New Private Placement has terminated in accordance with its terms. The Company continues to explore opportunities relating to the refinancing of its term loan with CIBC.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2023
Accounting Policies [Abstract]
Reverse Stock Split	Reverse Stock Split. At a special meeting held on February 7, 2023, the Company’s stockholders approved the Reverse Stock Split with a ratio within a range of between 1-for-5 and 1-for-25 , with the exact ratio to be set at the discretion of the Company’s Board of Directors. On September 19, 2023, the Board of Directors approved a ratio of 1-for-20 for the reverse stock split (Reverse Stock Split), which became effective on September 29, 2023 . As of the effective date, every twenty issued and outstanding shares of common stock was converted into one share of common stock, The common stock began trading on a reverse split-adjusted basis on the Nasdaq at the opening of trading on October 2, 2023. All issued and outstanding common stock and per share amounts contained in the financial statements have been retroactively adjusted to reflect this Reverse Stock Split for all periods presented. In addition, a proportionate adjustment was made to the per share exercise price and the number of shares issuable upon the exercise and/or vesting of all outstanding stock options, restricted stock units and warrants to purchase shares of common stock. A proportionate adjustment was also made to the number of shares reserved for issuance pursuant to the Company’s equity incentive compensation plans to reflect the Reverse Stock Split. No fractional shares of common stock were issued as a result of the Reverse Stock Split. Par value of common stock and preferred stock remained unchanged. The common stock par value and additional paid-in-capital line items contained in the financial statements were adjusted to account for the Reverse Stock Split for all periods presented. The Reverse Stock Split affected all stockholders uniformly and did not alter any stockholder's percentage interest in the Company's equity.
Basis of Presentation	Basis of presentation The accompanying financial statements have been prepared using accounting principles generally accepted in the United States of America (GAAP). Certain prior year amounts have been reclassified to conform to the current year presentation.
Unaudited interim financial information	Unaudited interim financial information The accompanying condensed balance sheet as of September 30, 2023, the condensed statements of operations, the condensed statements of stockholders’ equity and condensed statements of cash flows for the periods ended September 30, 2023 and 2022 are unaudited. The unaudited interim condensed financial statements have been prepared on the same basis as the 2022 audited annual financial statements and, in the opinion of management, reflect all adjustments, which include normal recurring adjustments, necessary for the fair statement of the Company’s financial position as of September 30, 2023 and the results of its operations for the three- and nine-month periods ended September 30, 2023 and 2022, and its cash flows for the nine-month periods ended September 30, 2023 and 2022. The financial data and other information disclosed in these notes related to the three- and nine-month periods ended September 30, 2023 and 2022 are also unaudited. The results for the three- and nine-month periods ended September 30, 2023 are not necessarily indicative of results to be expected for the year ending December 31, 2023, any other interim periods, or any future year or period. The balance sheet as of December 31, 2022 included herein was derived from the audited financial statements as of that date. Certain disclosures have been condensed or omitted from the interim condensed financial statements. These unaudited interim condensed financial statements should be read in conjunction with the audited annual financial statements and related notes. The significant accounting policies used in the preparation of the unaudited condensed financial statements for the three- and nine-month periods ended September 30, 2023 and 2022, are consistent with those discussed in Note 2 to the audited financial statements and notes thereto for the year ended December 31, 2022, included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022 filed with the Securities and Exchange Commission (SEC) on March 22, 2023. There have been no significant changes in the significant accounting policies or critical accounting estimates since December 31, 2022, except for the accounting policy related to FASB Accounting Standards Update (ASU) 2016-13, Financial Instruments-Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments discussed below.
Use of Estimates	Use of estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the 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 periods. Although these estimates are based on the Company’s knowledge of current events and actions it may undertake in the future, actual results may ultimately materially differ from these estimates and assumptions. Significant estimates and assumptions include accounts receivable allowances, inventory allowances, recoverability of long-term assets including definite-lived intangible assets, revaluation of equity instruments and equity-linked instruments, stock-based compensation, contingent consideration liability, deferred tax assets and related valuation allowances, impact of contingencies and the Company’s incremental borrowing rate used to calculate lease assets .
Change in Accounting Estimate	Change in accounting estimate In accordance with our policy, the Company reviews the estimated useful lives of its fixed assets on an ongoing basis. This review, which included a study of historic replacement requirements, indicated that the actual lives of equipment under customer usage agreements were longer than the estimated useful lives used for depreciation purposes. As a result, effective January 1, 2023, the Company changed its estimate of the useful lives of equipment under customer usage agreements from three to five years . The effect of this change in estimate was to reduce depreciation expense by $ 0.3 million and $ 0.8 million, decrease net loss by $ 0.3 million and $ 0.8 million, and decrease basic and diluted loss per share by an immaterial amount, for the three and nine months ended September 30, 2023, respectively.
Fair value of financial instruments	Fair value of financial instruments The carrying amounts of the Company’s financial instruments, including cash and cash equivalents, accounts receivable and accounts payable, approximate their fair value due to the short-term nature of these assets and liabilities. Based on the borrowing rates currently available to the Company for debt with similar terms and consideration of default and credit risk, the carrying value of the term loan approximates its fair value and is classified as a Level 2 liability.
Concentration of credit risk	Concentration of credit risk Financial instruments that potentially subject the Company to concentrations of risk consist principally of cash, cash equivalents and accounts receivable. The Company maintains its cash and cash equivalents balances with established financial institutions and, at times, such balances with any one financial institution may be in excess of the Federal Deposit Insurance Corporation (FDIC) insured limits. The Company maintains long-term debt with a variable interest rate that resets monthly and has been subject to the recent inflationary rise in interest rates during the past year. Additionally, the Company is subject to interest rate risk when its long-term loan become due and in the event of a refinancing. The Company earns revenue from sale of disposable devices and controllers to customers such as hospitals, ambulatory surgical centers and physician offices. The Company’s accounts receivable are derived from revenue earned from customers. The Company performs ongoing credit evaluations of its customers’ financial condition and generally requires no collateral from its customers. At September 30, 2023 and 2022, and for the periods then ended, no customer accounted for more than 10.0% of accounts receivable or revenue.
Concentration of suppliers	Concentration of suppliers The Company purchases certain components of its products from a single or small number of suppliers. A change in or loss of these suppliers could cause a delay in filling customer orders and a possible loss of sales, which could adversely affect our results of operations; however, management believes that suitable replacement suppliers could be obtained in such an event.
Accounts Receivable and Estimated Credit Losses	Accounts Receivable and Estimated Credit Losses The Company adopted ASU 2016-13, Financial Instruments-Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments , effective January 1, 2023 using the modified retrospective method. The adoption of this standard did not have a material cumulative effect on opening accumulated deficit as of January 1, 2023 and did not have a material impact on the Company’s financial statements for the three and nine months ended September 30, 2023. As of January 1, 2023, accounts receivable are recorded at invoice value, net of the Company's reserve for estimated credit losses. The Company applies its loss-rate method to measure its estimated credit loss for receivables using its historical collection experience, current and ongoing evaluation of customer balances including transaction history, aging status and financial condition of its customers, plus reasonable and supportable forecast of future economic market conditions. Specific credit loss reserve amounts are established to record the appropriate reserve for the Company's current estimate of credit losses (CECL) reserves for its pool of identified customers that have an identified risk of default. A general credit loss reserve is then established based upon the Company’s assessment of estimated credit losses for its remaining receivables pool based on its loss-rate method. Balances are written-off when they are ultimately determined to be uncollectible. The following table summarizes th e year-to-date activity in the reserve for credit loss account (in thousands): January 1, 2023 $ 542 Amounts charged to costs and expenses 92 Write-offs ( 40 ) September 30, 2023 $ 594
Advertising costs	Advertising costs Expenses related to advertising of produ cts are charged to sales and marketing expense as incurred. During the three and nine months ended September 30, 2023, the Company incurred none and $ 0.1 million, respectively, in advertising expenses. During the three and nine months ended September 30, 2022, the Company incurred $ 0.2 million and $ 0.4 million, respectively, in advertising expenses.
Net loss per share	Net loss per share Basic net loss per share is calculated by dividing the net loss by the weighted-average number of common shares outstanding during the period, without consideration for potentially dilutive securities. Diluted net loss per share is computed by dividing the net loss by the weighted-average number of common shares and potentially dilutive securities outstanding for the period. For purposes of the diluted net loss per share calculation, redeemable convertible preferred stock warrants, convertible notes, common stock subject to repurchase, restricted stock units and common stock options are considered to be potentially dilutive securities. Basic and diluted net loss per share is presented. The Company also considers the shares issued upon the early exercise of stock options subject to repurchase to be participating securities, because holders of such shares have non-forfeitable dividend rights in the event a dividend is paid on common stock. Because the Company has reported a net loss for the three- and nine-month periods ended September 30, 2023 and 2022, diluted net loss per common share is the same as basic net loss per common share for all periods presented.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2023
Accounting Policies [Abstract]
Schedule Of Reserve For Credit Loss Account	The following table summarizes th e year-to-date activity in the reserve for credit loss account (in thousands): January 1, 2023 $ 542 Amounts charged to costs and expenses 92 Write-offs ( 40 ) September 30, 2023 $ 594

Revenue (Tables)

Revenue (Tables)	9 Months Ended
	Sep. 30, 2023
Revenue from Contract with Customer [Abstract]
Schedule of Disaggregation of Revenue	Disaggregation of revenue For the Three Months Ended September 30, For the Nine Months Ended September 30, 2023 2022 2023 2022 Minerva ES 43.7 % 46.8 % 45.0 % 45.1 % Genesys HTA 25.2 % 28.4 % 26.6 % 29.5 % Symphion 30.1 % 24.1 % 27.4 % 24.8 % Other 1.0 % 0.7 % 1.0 % 0.6 % 100 % 100 % 100 % 100 %
Schedule of Contract Balance	The Company’s contract balances consist of the following (in tho usands): September 30, December 31, 2023 2022 Accounts receivable, net $ 7,569 $ 7,244 Contract liability—current (see Note 6) $ 202 $ 339

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2023
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Schedule of Assets and Liabilities Measured at Fair Value on Recurring Basis	The following tables summarize the type s of assets and liabilities measured at fair value on a recurring basis by level within the fair value hierarchy (in thousands): September 30, 2023 Level 1 Level 2 Level 3 Total Assets: Cash equivalents: Money market funds $ 9,077 $ — $ — $ 9,077 Total financial assets $ 9,077 $ — $ — $ 9,077 December 31, 2022 Level 1 Level 2 Level 3 Total Assets: Cash equivalents: Money market funds $ 3,149 $ — $ — $ 3,149 Total financial assets $ 3,149 $ — $ — $ 3,149
Schedule of Change in Fair Value of the Contingent Consideration Liability	The change in fair value of the contingent consideration liability du e to BSC is summarized below (in thousands): Contingent Fair value, December 31, 2021 $ 14,094 Change in fair value ( 151 ) Payment ( 5,000 ) Ending fair value, March 31, 2022 8,943 Change in fair value ( 3,943 ) Fair value, June 30, 2022 5,000 Change in fair value - Fair value, September 30, 2022 $ 5,000

Balance Sheet Components (Table

Balance Sheet Components (Tables)	9 Months Ended
	Sep. 30, 2023
Balance Sheet Components [Abstract]
Schedule of Cash and Cash Equivalents	The Company’s cash and cash equivalents cons ist of the following (in thousands): September 30, December 31, 2023 2022 Cash $ 2,048 $ 3,793 Cash equivalents: Money market funds 9,077 3,149 Total cash and cash equivalents $ 11,125 $ 6,942
Schedule of Inventory	Inventory co nsists of the following (in thousands): September 30, December 31, 2023 2022 Finished goods $ 8,845 $ 7,142 Component materials 9,338 9,708 Total inventory $ 18,183 $ 16,850
Prepaid Expenses and Other Current Assets	Prepaid expenses and other current assets consis t of the following (in thousands): September 30, December 31, 2023 2022 Prepaid expenses $ 2,402 $ 2,164 Prepaid insurance 326 1,560 Other current assets 317 755 Total prepaid expenses and other current assets $ 3,045 $ 4,479
Property and Equipment, Net	Property and equipment, net consist of the following (in thousands): September 30, December 31, Useful life (years) 2023 2022 Computers and software 2 $ 359 $ 343 Machinery and equipment 3 666 664 Furniture and fixtures 7 48 48 Tools and dies 2 906 900 Construction in progress — 94 131 Equipment under customer usage agreements 5 14,278 13,226 Leasehold improvements Lesser of useful life or lease term 155 155 16,506 15,467 Less: accumulated depreciation and amortization ( 11,079 ) ( 10,425 ) Property and equipment, net $ 5,427 $ 5,042
Schedule of Intangible Assets, Net	Intangible assets, net consist of the following (in thousands): September 30, 2023 Remaining life (years) Gross Carrying Value Accumulated Amortization Net Carrying Value Trademarks 3.2 $ 3,969 $ ( 2,061 ) $ 1,908 Developed technology 6.7 30,819 ( 10,401 ) 20,418 Customer relationships — 13,466 ( 13,466 ) — Total intangible assets $ 48,254 $ ( 25,928 ) $ 22,326 December 31, 2022 Remaining life (years) Gross Carrying Value Accumulated Amortization Net Carrying Value Trademarks 3.9 $ 3,969 $ ( 1,603 ) $ 2,366 Developed technology 7.4 30,819 ( 8,090 ) 22,729 Customer relationships 0.4 13,466 ( 11,783 ) 1,683 Total intangible assets $ 48,254 $ ( 21,476 ) $ 26,778
Schedule of Future Amortization Expense of Intangible Assets Related to Acqusition of Assets	Future amortization expense of intangible assets related to the acquisition of assets from BSC as of September 30, 2023 is as follows (in thousands): 2023 (remaining three months) $ 923 2024 3,693 2025 3,693 2026 3,614 2027 3,082 Thereafter 7,321 Total $ 22,326
Schedule of Accrued Compensation	Accrued compensation co nsists of the following (in thousands): September 30, December 31, 2023 2022 Accrued vacation $ 1,391 $ 1,559 Accrued bonuses 1,745 1,248 Accrued commissions 337 730 Other accrued personnel related expenses 104 164 Total accrued compensation $ 3,577 $ 3,701
Schedule of Accrued Liabilities	Accrued liabilities consist of the following (in th ousands): September 30, December 31, 2023 2022 Accrual for litigation $ — $ 2,000 Accrued professional fees 240 643 Accrued sales and use taxes 121 271 Accrual for inventory in transit 475 663 Contract liability 202 339 Accrued interest expense 350 321 Others 978 1,287 Total accrued liabilities $ 2,366 $ 5,524

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2023
Debt Disclosure [Abstract]
Schedule of Debt	The CIBC Loan consists of the following (in t housands): September 30, December 31, 2023 2022 Term loan principal $ 40,000 $ 40,000 Less: Debt discount and debt issuance cost ( 466 ) ( 665 ) Accrued interest payable 350 321 Term loan $ 39,884 $ 39,656
Schedule of Contractual Maturities of Financing Obligations	As of September 30, 2023, the aggregate future payments under the CIBC Loan (including interest payments) are as follows (in thousands): 2023 (remaining three months) $ 3,599 2024 16,482 2025 15,053 2026 12,537 Total 47,671 Less: unamortized debt discounts and issuance costs ( 466 ) Less: interest ( 7,671 ) Long-term debt $ 39,534

Operating Lease (Tables)

Operating Lease (Tables)	9 Months Ended
	Sep. 30, 2023
Leases [Abstract]
Summary of Lease Costs	The following table contains a summary of the lease costs recognized under ASC 842 and other information pertaining to the Company’s operating leases for the three- and nine-month periods ended September 30, 2023 and 2022 : For Three Months Ended September 30, For Nine Months Ended September 30, 2023 2022 2023 2022 Lease Cost Operating lease cost $ 281 $ 163 $ 647 $ 490 Variable lease cost 40 38 203 186 Total lease cost $ 321 $ 201 $ 850 $ 676 Other Information Operating cash flows used for lease liabilities $ 265 $ 214 $ 709 $ 631 Right of use asset acquired under operating lease on the adoption of ASC 842 $ - $ - $ - $ 894 Right-of-use assets obtained in exchange for new operating lease liabilities $ - $ - $ 4,206 $ - Remaining lease terms and discount rates for our facility lease as of September 30, 2023 and December 31, 2022 were as follows: September 30, December 31, 2023 2022 Incremental borrowing rate 12.25 % 4.00 % Remaining lease term (in years) 4.7 0.4
Schedule of Future Minimum Rental Payments for Operating Leases	The future minimum lease payments under all non-cancelable operating lease obligations as of September 30, 2023 were as follows (in thousands): September 30, 2023 2023 (remaining three months) $ 353 2024 1,081 2025 1,114 2026 1,147 2027 1,182 Thereafter 398 Total undiscounted lease payments 5,275 Less: imputed interest ( 1,258 ) Total operating lease liability 4,017 Less: current portion of operating lease liability 623 Operating lease liability, net of current portion $ 3,394

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	9 Months Ended
	Sep. 30, 2023
Equity [Abstract]
Schedule of common stock warrants	As of September 30, 2023, the Company`s outstanding warrants to purchase shares of common stock consisted of the following: Issuance Date Number of Shares of Common Stock Issuable Exercise Price Classification Expiration Date May 9, 2017 1,696 $ $ 226.20 Equity May 8, 2027 July 19, 2019 2,192 $ $ 226.20 Equity July 18, 2029 3,888
Schedule of Shares Reserved for Future Issuance	The Company has shares of common stock reserved for future issuances as follows: September 30, December 31, 2023 2022 Warrants to purchase common stock 3,888 3,888 Common stock options issued and outstanding 1,310,122 114,530 Common stock available for future grants 724,243 18,705 Restricted stock units issued and outstanding 24,782 62,353 Common stock available for ESPP 173,470 3
Schedule of Stock Option Activity	A summar y of stock option activity is set forth below (in thousands, except share and per share data): Number of Weighted Weighted Aggregate Outstanding, December 31, 2022 114,357 $ 166.72 8.0 $ 1 Options granted 1,271,964 $ 5.58 Options exercised ( 1,591 ) $ 6.53 Options forfeited or cancelled or expired ( 74,608 ) $ 48.96 Outstanding, September 30, 2023 1,310,122 $ 9.2 $ - Shares exercisable September 30, 2023 182,188 $ 79.83 7.9 $ - Vested and expected to vest, September 30, 2023 1,310,122 $ 17.18 9.2 $ -
Schedule of Restricted Stock Units	A summary of RSU activity is set forth below: Number of Weighted Average Grant Date Fair Value Unvested, December 31, 2022 62,340 $ 51.65 Released ( 31,212 ) $ 51.41 Forfeited or cancelled ( 6,346 ) $ 52.17 Unvested, September 30, 2023 24,782 $ 51.83
Summary of Stock-Based Compensation Expense	Total stock-based compensation expense recognized was as follows (in thous ands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Cost of goods sold $ 27 $ 97 $ 109 $ 240 Sales and marketing 258 729 1,229 1,918 Research and development 5 4 21 33 General and administrative 543 1,147 1,846 2,985 Total $ 833 $ 1,977 $ 3,205 $ 5,176 The above stock-based compensation expense related to the following equity-based awards (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Stock options $ 674 $ 954 $ 2,459 $ 2,969 RSU 154 852 706 1,982 ESPP 5 171 40 225 Total $ 833 $ 1,977 $ 3,205 $ 5,176
Schedule of Fair Value of Stock Options Estimated Using Weighted-Average Assumptions	The fair value of stock options was estimated using the following weighted-average assumptions: Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Expected dividends 0 % 0 % 0 % 0 % Expected volatility 78.10 % 72.2 % 77.4 %- 78.1 % 70.8 %- 72.2 % Risk-free interest rate 4.0 % 2.8 % 4.2 % 1.9 %- 3.0 % Expected term 6 years 6 years 6 years 6 years

Net Loss Per Share Attributab_2

Net Loss Per Share Attributable To Common Stockholders (Tables)	9 Months Ended
	Sep. 30, 2023
Earnings Per Share [Abstract]
Schedule of Computation of Basic and Diluted Net Loss Per Share	Th e following table sets forth the computation of basic and diluted net loss per share attributable to common stockholders which is computed by dividing the net loss by the weighted-average number of common stock outstanding for the period. For the Three Months Ended September 30, For the Nine Months Ended September 30, (in thousands, except share and per share amounts) 2023 2022 2023 2022 Numerator Net loss attributable to common stockholders $ ( 7,181 ) $ ( 11,329 ) $ ( 27,205 ) $ ( 27,867 ) Denominator: Weighted-average common stock outstanding 8,872,998 1,430,056 7,805,772 1,430,272 Net loss per share attributable to common stockholders, basic and diluted $ ( 0.81 ) $ ( 7.92 ) $ ( 3.49 ) $ ( 19.48 )
Schedule of Anti-dilutive Securities Outstanding in Common Stock Equivalent Excluded from Computation of Diluted Weighted Average Shares Outstanding	The following table indicates the number of potentially dilutive securities excluded from the calculation of Diluted net income (loss) per common share because their inclusion would have been anti-dilutive. The number of shares is as of the end of each period: September 30, 2023 2022 Common stock warrants 3,888 3,888 Unvested early exercised common stock options 4,761 13,875 Options to purchase common stock 1,310,322 109,166 Unvested restricted stock units 24,782 85,161

Formation and Business of the_2

Formation and Business of the Company - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands			3 Months Ended						9 Months Ended
	Feb. 09, 2023	Dec. 27, 2022	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Net Loss			$ 7,181	$ 8,681	$ 11,343	$ 11,329	$ 5,613	$ 10,925	$ 27,205	$ 27,867
Accumulated deficit			(310,718)						(310,718)		$ (283,668)
Cash and cash equivalents			$ 11,125						$ 11,125		$ 6,942
Common stock, par value			$ 0.001						$ 0.001		$ 0.001
Canadian Imperial Bank of Commerce (CIBC)
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Outstanding long-term debt			$ 39,534						$ 39,534
Purchase Agreement
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Gross proceeds of private placement	$ 30,000
Private placement agent fees and offering expenses	$ 3,200
Purchasers | Purchase Agreement | Private placement
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Aggregate number of shares agreed to be sold		7,331,377
Common stock, par value		$ 0.001
Purchase price per share		$ 4.092
Premium Percentage		25%
Volume Weighted Average Price Trailing Period		5 days

Summary of significant accoun_4

Summary of significant accounting policies - Additional Information (Details) $ in Thousands			3 Months Ended						9 Months Ended		12 Months Ended
	Sep. 29, 2023	Feb. 07, 2023	Sep. 30, 2023 USD ($)	Jun. 30, 2023 USD ($)	Mar. 31, 2023 USD ($)	Sep. 30, 2022 USD ($)	Jun. 30, 2022 USD ($)	Mar. 31, 2022 USD ($)	Sep. 30, 2023 USD ($) Customer	Sep. 30, 2022 USD ($) Customer	Dec. 31, 2022
Financing Receivable Impaired [Line Items]
Reverse stock split ratio		0.05	0.05						0.05		0.05
Reverse stock split ratio, effective date	Sep. 29, 2023
Reverse stock split ratio, description	every twenty issued and outstanding shares of common stock was converted into one share of common stock,
Number of customer accounted for accounts receivable or revenue | Customer									0	0
Advertising expenses			$ 0			$ 200			$ 100	$ 400
Decrease net loss			(7,181)	$ (8,681)	$ (11,343)	$ (11,329)	$ (5,613)	$ (10,925)	(27,205)	$ (27,867)
Maximum
Financing Receivable Impaired [Line Items]
Reverse stock split ratio		0.2
Minimum
Financing Receivable Impaired [Line Items]
Reverse stock split ratio		0.04
Customer Usage Agreements
Financing Receivable Impaired [Line Items]
Decrease in depreciation expense			300						800
Decrease net loss			$ 300						$ 800
Customer Usage Agreements | Maximum
Financing Receivable Impaired [Line Items]
Property and equipment, useful life			5 years						5 years
Customer Usage Agreements | Minimum
Financing Receivable Impaired [Line Items]
Property and equipment, useful life			3 years						3 years

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Schedule Of Reserve For Credit Loss Account (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2023 USD ($)
Accounting Policies [Abstract]
Beginnning balance	$ 542
Amounts charged to costs and expenses	92
Write-offs	(40)
Ending balance	$ 594

Recent Accounting Pronounceme_2

Recent Accounting Pronouncements - Additional Information (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Jan. 01, 2023	Dec. 31, 2022
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Retained earnings	$ (310,718)		$ (283,668)
ASU 2016 -13
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted [true false]	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date		Jan. 01, 2023
Derecognized in allowance for doubtful accounts		$ 700
CECL reserve		500
ASU 2016 -13 | Cumulative Effect Period Of Adoption Adjustment
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Retained earnings		$ 200

Revenue - Schedule of Disaggreg

Revenue - Schedule of Disaggregation of Revenue (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Jun. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Disaggregation Of Revenue [Line Items]
Disaggregation of revenue, percentage	100%	100%	100%	100%
Minerva ES
Disaggregation Of Revenue [Line Items]
Disaggregation of revenue, percentage	43.70%	46.80%	45%	45.10%
Genesys HTA
Disaggregation Of Revenue [Line Items]
Disaggregation of revenue, percentage	25.20%	28.40%	26.60%	29.50%
Symphion
Disaggregation Of Revenue [Line Items]
Disaggregation of revenue, percentage	30.10%	24.10%	27.40%	24.80%
Other
Disaggregation Of Revenue [Line Items]
Disaggregation of revenue, percentage	1%	0.70%	1%	0.60%

Revenue - Additional Informatio

Revenue - Additional Information (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Revenue from Contract with Customer [Abstract]
Percentage of revenue subject to point-in-time recognition	99.90%	99.90%	99.90%	99.90%
Percentage of revenue on sale of extended warranties on capital equipment	0.10%	0.10%	0.10%	0.10%
Percentage of total revenue derived from sale of single-use (disposable) products	98.70%	97%	98.50%	98%

Revenue - Schedule of Contract

Revenue - Schedule of Contract Balance (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Contract with Customer, Contract Asset, Contract Liability, and Receivable [Abstract]
Accounts receivable, net	$ 7,569	$ 7,244
Contract liability-current (see Note 6)	$ 202	$ 339

Fair Value Measurements - Sched

Fair Value Measurements - Schedule of Assets and Liabilities Measured at Fair Value on Recurring Basis (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Cash equivalents:
Money market funds	$ 9,077	$ 3,149
Total financial assets	9,077	3,149
Level 1
Cash equivalents:
Money market funds	9,077	3,149
Total financial assets	$ 9,077	$ 3,149

Fair Value - Summary of Changes

Fair Value - Summary of Changes in Fair Value of the Contingent consideration Liability (Details) - USD ($) $ in Thousands	3 Months Ended
	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022
Fair Value Disclosures [Abstract]
Beginning fair value	$ 5,000	$ 8,943	$ 14,094
Change in fair value	0	(3,943)	(151)
Payment			(5,000)
Ending fair value	$ 5,000	$ 5,000	$ 8,943

Balance Sheet Components - Sche

Balance Sheet Components - Schedule of Cash and Cash Equivalents (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Balance Sheet Components [Abstract]
Cash	$ 2,048	$ 3,793
Cash equivalents:
Money market funds	9,077	3,149
Total cash and cash equivalents	$ 11,125	$ 6,942

Balance Sheet Components - Sc_2

Balance Sheet Components - Schedule of Inventory (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Balance Sheet Components [Abstract]
Finished goods	$ 8,845	$ 7,142
Component materials	9,338	9,708
Total inventory	$ 18,183	$ 16,850

Balance Sheet Components - Prep

Balance Sheet Components - Prepaid Expenses and Other Current Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Balance Sheet Components [Abstract]
Prepaid expenses	$ 2,402	$ 2,164
Prepaid insurance	326	1,560
Other current assets	317	755
Total prepaid expenses and other current assets	$ 3,045	$ 4,479

Balance Sheet Components - Sc_3

Balance Sheet Components - Schedule of Property and Equipment, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Balance Sheet Components [Line Items]
Property and equipment, gross	$ 16,506	$ 15,467
Less: accumulated depreciation and amortization	(11,079)	(10,425)
Property and equipment, net	5,427	5,042
Computer and Software
Balance Sheet Components [Line Items]
Property and equipment, gross	$ 359	343
Property and equipment, useful life	2 years
Machinery and Equipment
Balance Sheet Components [Line Items]
Property and equipment, gross	$ 666	664
Property and equipment, useful life	3 years
Furniture and Fixtures
Balance Sheet Components [Line Items]
Property and equipment, gross	$ 48	48
Property and equipment, useful life	7 years
Tools and Dies
Balance Sheet Components [Line Items]
Property and equipment, gross	$ 906	900
Property and equipment, useful life	2 years
Construction in Progress
Balance Sheet Components [Line Items]
Property and equipment, gross	$ 94	131
Equipment Under Customer Usage Agreements
Balance Sheet Components [Line Items]
Property and equipment, gross	$ 14,278	13,226
Property and equipment, useful life	5 years
Leasehold Improvements
Balance Sheet Components [Line Items]
Property and equipment, gross	$ 155	$ 155
Property and equipment, useful life, description	us-gaap:UsefulLifeShorterOfTermOfLeaseOrAssetUtilityMember

Balance Sheet Components - Addi

Balance Sheet Components - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Balance Sheet Components [Line Items]
Depreciation and amortization expense on property and equipment	$ 0.5	$ 0.6	$ 1.5	$ 1.9
Amortization expense on intangible assets	0.9	2	4.5	6.1
Inventory in transit and recognized into accounts payable	0.2		0.2
Customer Usage Agreements
Balance Sheet Components [Line Items]
Decrease in depreciation expense	0.3		0.8
Equipment Under Customer Usage Agreements
Balance Sheet Components [Line Items]
Depreciation and amortization expense on property and equipment	$ 0.5	$ 0.6	$ 1.3	$ 1.7

Balance Sheet Components - Sc_4

Balance Sheet Components - Schedule of Intangible Assets, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Balance Sheet Components [Line Items]
Gross Carrying Value	$ 48,254	$ 48,254
Accumulated Amortization	(25,928)	(21,476)
Net Carrying Value	22,326	26,778
Trademarks
Balance Sheet Components [Line Items]
Gross Carrying Value	3,969	3,969
Accumulated Amortization	(2,061)	(1,603)
Net Carrying Value	$ 1,908	$ 2,366
Remaining life (years)	3 years 2 months 12 days	3 years 10 months 24 days
Developed Technology
Balance Sheet Components [Line Items]
Gross Carrying Value	$ 30,819	$ 30,819
Accumulated Amortization	(10,401)	(8,090)
Net Carrying Value	$ 20,418	$ 22,729
Remaining life (years)	6 years 8 months 12 days	7 years 4 months 24 days
Customer Relationships
Balance Sheet Components [Line Items]
Gross Carrying Value	$ 13,466	$ 13,466
Accumulated Amortization	$ (13,466)	(11,783)
Net Carrying Value		$ 1,683
Remaining life (years)		4 months 24 days

Balance Sheet Components - Sc_5

Balance Sheet Components - Schedule of Future Amortization Expense of Intangible Assets Related to Acquisition of Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Balance Sheet Components [Abstract]
2023 (remaining three months)	$ 923
2024	3,693
2025	3,693
2026	3,614
2027	3,082
Thereafter	7,321
Net Carrying Value	$ 22,326	$ 26,778

Balance Sheet Components - Sc_6

Balance Sheet Components - Schedule of Accrued Compensation (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Balance Sheet Components [Abstract]
Accrued vacation	$ 1,391	$ 1,559
Accrued bonuses	1,745	1,248
Accrued commissions	337	730
Other accrued personnel related expenses	104	164
Total accrued compensation	$ 3,577	$ 3,701

Balance Sheet Components - Sc_7

Balance Sheet Components - Schedule of Accrued Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Balance Sheet Components [Abstract]
Accrual for litigation		$ 2,000
Accrued professional fees	$ 240	643
Accrued sales and use taxes	121	271
Accrual for inventory in transit	475	663
Contract liability	202	339
Accrued interest expense	350	321
Others	978	1,287
Total accrued liabilities	$ 2,366	$ 5,524

Debt - CIBC Term loan - Additio

Debt - CIBC Term loan - Additional Information (Details) - CIBC Term Loan - USD ($)		3 Months Ended		9 Months Ended
	Oct. 08, 2021	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Debt Instrument [Line Items]
Debt financing	$ 40,000,000	$ 40,000,000		$ 40,000,000		$ 40,000,000
Debt instrument effective interest rate		12.50%		12.50%
Debt instrument interest rate increase upon occurance and continuance of event of default	5%
Payments of loan costs	$ 1,000
Interest Expense related to debt discount , debt issuance costs and exit fees		$ 100,000	$ 100,000	$ 200,000	$ 200,000
Interest expense on debt		$ 1,200,000	$ 900,000	$ 3,400,000	$ 2,200,000
Prime Rate
Debt Instrument [Line Items]
Debt instument interest rate	2.50%

Debt - CIBC Term Loan - Schedul

Debt - CIBC Term Loan - Schedule of Debt (Details) - CIBC Term Loan - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022	Oct. 08, 2021
Debt Instrument [Line Items]
Term loan principal	$ 40,000	$ 40,000	$ 40,000
Less: Debt discount and debt issuance cost	(466)	(665)
Accrued interest payable	350	321
Term loan	$ 39,884	$ 39,656

Debt - Schedule of Contractual

Debt - Schedule of Contractual Maturities of Financing Obligations (Details) - CIBC Term Loan - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
2023 (remaining three months)	$ 3,599
2024	16,482
2025	15,053
2026	12,537
Total	47,671
Less: unamortized debt discounts and issuance costs	(466)	$ (665)
Less: interest	(7,671)
Long-term debt	$ 39,534

Operating Lease - Additional In

Operating Lease - Additional Information (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Lessee, Lease, Description [Line Items]
Operating lease right-of-use asset	$ 3,996,000	$ 894,000	$ 3,996,000	$ 894,000	$ 270,000
Operating lease liabilities	4,017,000		4,017,000
Finance lease liabilities	$ 0		$ 0
ASC 842
Lessee, Lease, Description [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted [true false]	true		true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Jan. 01, 2022		Jan. 01, 2022
Santa Clara
Lessee, Lease, Description [Line Items]
Rent expense recognized	$ 300,000	$ 200,000	$ 700,000	$ 500,000
California
Lessee, Lease, Description [Line Items]
Lease commenced date			Jun. 01, 2023
Lease expiration date			May 31, 2028
Base rent payments			$ 88,341
Incremental annual rental payment percentage			3%
Mission Park
Lessee, Lease, Description [Line Items]
Letters of credit	300,000		$ 300,000
Office Leases | Santa Clara
Lessee, Lease, Description [Line Items]
Letters of credit	$ 500,000		$ 500,000

Operating Lease - Summary of Le

Operating Lease - Summary of Lease Costs (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Lease Cost
Operating lease cost	$ 281	$ 163	$ 647	$ 490
Variable lease cost	40	38	203	186
Total lease cost	321	201	850	676
Other Information
Operating cash flows used for lease liabilities	265	214	709	631
Right of use asset acquired under operating lease on the adoption of ASC 842	$ 3,996	$ 894	3,996	$ 894	$ 270
Right-of-use assets obtained in exchange for new operating lease liabilities			$ 4,206
Incremental borrowing rate	12.25%		12.25%		4%
Remaining lease term (in years)	4 years 8 months 12 days		4 years 8 months 12 days		4 months 24 days

Operating Lease - Schedule of M

Operating Lease - Schedule of Maturities of Operating Lease Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Lessee, Operating Lease, Liability, to be Paid, Fiscal Year Maturity [Abstract]
2023 (remaining three months)	$ 353
2024	1,081
2025	1,114
2026	1,147
2027	1,182
Thereafter	398
Total undiscounted lease payments	5,275
Less: imputed interest	(1,258)
Total operating lease liability	4,017
Less: current portion of operating lease liability	623	$ 355
Operating lease liability, net of current portion	$ 3,394

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Tax Disclosure [Abstract]
Income tax expense	$ 3		$ 42

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands				3 Months Ended		9 Months Ended
	Jun. 01, 2023	Dec. 27, 2022	Dec. 01, 2022	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Subsidiary or Equity Method Investee [Line Items]
Common stock, shares authorized				300,000,000		300,000,000		100,000,000
Common stock, par value				$ 0.001		$ 0.001		$ 0.001
Fair value of options vested						$ 2,600	$ 2,900
Weighted average grant date fair value						$ 3.96	$ 42.29
Unrecognized stock-based compensation expense				$ 6,300		$ 6,300
Unrecognized stock-based compensation expense, weighted-average recognition period						3 years 1 month 6 days
Repurchase of common stock				0	0	0	0
Shares subject to repurchase				4,761		4,761		9,401
Aggregate amounts of not yet vested early stock				$ 100		$ 100		$ 100
Preferred stock, shares authorized				15,000,000		15,000,000		5,000,000
Preferred stock, par value				$ 0.001		$ 0.001		$ 0.001
Risk-free interest rate				4%	2.80%	4.20%
Dividend rate				0%	0%	0%	0%
Expected term				6 years	6 years	6 years	6 years
Volatility				78.10%	72.20%
Compensation expense				$ 833	$ 1,977	$ 3,205	$ 5,176
ESPP
Subsidiary or Equity Method Investee [Line Items]
Unrecognized stock-based compensation expense, weighted-average recognition period						3 months 18 days
Compensation expense					100		200
Restricted Stock Units
Subsidiary or Equity Method Investee [Line Items]
Unrecognized stock-based compensation expense				1,100		$ 1,100
Unrecognized stock-based compensation expense, weighted-average recognition period						2 years 6 months
Compensation expense				$ 154	$ 852	$ 706	$ 1,982
Restricted Stock Units | 2021 Plan
Subsidiary or Equity Method Investee [Line Items]
Number of shares, Granted				0
Tranche One | ESPP
Subsidiary or Equity Method Investee [Line Items]
Risk-free interest rate	4.61%		4.61%
Dividend rate	0%		0%
Expected term	6 months		6 months
Volatility	77.21%		77.21%
Tranche Two | ESPP
Subsidiary or Equity Method Investee [Line Items]
Risk-free interest rate	4.61%		4.61%
Dividend rate	0%		0%
Expected term	1 year		1 year
Volatility	76.29%		76.29%
Purchasers | Purchase Agreement | Private placement
Subsidiary or Equity Method Investee [Line Items]
Common stock, par value		$ 0.001
Aggregate number of shares agreed to be sold		7,331,377
Maximum | ESPP
Subsidiary or Equity Method Investee [Line Items]
Compensation expense				$ 100		$ 100

Stockholders' Equity - Schedule

Stockholders' Equity - Schedule of Common Stock Warrants (Details) - $ / shares	Jul. 19, 2019	May 09, 2017	Sep. 30, 2023
Equity [Abstract]
Issuance Date	Jul. 19, 2019	May 09, 2017
Number of Shares of Common Stock Issuable	2,192	1,696	3,888
Exercise Price	$ 226.2	$ 226.2
Classification	Equity	Equity
Expiration Date	Jul. 18, 2029	May 08, 2027

Stockholders' Equity - Schedu_2

Stockholders' Equity - Schedule of Shares Reserved for Future Issuance (Details) - shares	Jun. 30, 2023	Dec. 31, 2022
Class Of Stock [Line Items]
Warrants to purchase common stock	3,888	3,888
Common stock options issued and outstanding	1,310,122	114,530
Common stock available for future grants	724,243	18,705
Restricted stock units issued and outstanding	24,782	62,353
ESPP
Class Of Stock [Line Items]
Common stock available for future grants	173,470	3

Stockholders' Equity - Schedu_3

Stockholders' Equity - Schedule of Stock Option Activity (Details) $ / shares in Units, $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2023 $ / shares shares	Dec. 31, 2022 USD ($) $ / shares shares
Equity [Abstract]
Number of Shares Underlying Outstanding Options, Beginning balance	114,357
Number of Shares Underlying Outstanding Options, Granted	1,271,964
Number of Shares Underlying Outstanding Options, Exercised	(1,591)
Number of Shares Underlying Outstanding Options, Forfeited or Cancelled or Expirred	(74,608)
Number of Shares Underlying Outstanding Options, Ending balance	1,310,122	114,357
Number of Shares Underlying Outstanding Options, Shares Exercisable	182,188
Number of Shares Underlying Outstanding Options, Vested and Expected to Vest	1,310,122
Weighted Average Exercise Price, Options granted | $ / shares	$ 5.58
Weighted Average Exercise Price, Options exercised | $ / shares	6.53
Weighted Average Exercise Price, Options forfeited or cancelled or expired | $ / shares	48.96
Weighted Average Exercise Price, Outstanding ending balance | $ / shares		$ 166.72
Weighted Average Exercise Price, Shares exercisable | $ / shares	79.83
Weighted Average Exercise Price, vested and expected to vest | $ / shares	$ 17.18
Weighted Average Remaining Contractual Term (in years), Outstanding	9 years 2 months 12 days	8 years
Weighted Average Remaining Contractual Term (in years), Shares exercisable	7 years 10 months 24 days
Weighted Average Remaining Contractual Term (in years), Vested and Expected to Vest	9 years 2 months 12 days
Aggregate Intrinsic Value, Outstanding | $		$ 1

Stockholders' Equity - Schedu_4

Stockholders' Equity - Schedule of Restricted Stock Units (Details) - Restricted Stock Units	9 Months Ended
	Sep. 30, 2023 $ / shares shares
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Number of Shares Underlying Outstanding Restricted Stock, Unvested, Beginning balance | shares	62,340
Number of Shares Underlying Outstanding Restricted Stock, Released | shares	(31,212)
Number of Shares Underlying Outstanding Restricted Stock, Forfeited or cancelled | shares	(6,346)
Number of Shares Underlying Outstanding Restricted Stock, Unvested, Ending Balance | shares	24,782
Weighted Average Grant Date Fair Value, Unvested, Beginning balance | $ / shares	$ 51.65
Weighted Average Grant Date Fair Value, Unvested, Released | $ / shares	51.41
Weighted Average Grant Date Fair Value, Unvested, Forfeited or Cancelled | $ / shares	52.17
Weighted Average Grant Date Fair Value, Unvested, Ending Balance | $ / shares	$ 51.83

Stockholders' Equity -Summary o

Stockholders' Equity -Summary of Stock-Based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Class Of Stock [Line Items]
Stock-based compensation expense	$ 833	$ 1,977	$ 3,205	$ 5,176
Cost of Goods Sold
Class Of Stock [Line Items]
Stock-based compensation expense	27	97	109	240
Sales and Marketing
Class Of Stock [Line Items]
Stock-based compensation expense	258	729	1,229	1,918
Research and Development
Class Of Stock [Line Items]
Stock-based compensation expense	5	4	21	33
General and Administrative
Class Of Stock [Line Items]
Stock-based compensation expense	543	1,147	1,846	2,985
Stock Options
Class Of Stock [Line Items]
Stock-based compensation expense	674	954	2,459	2,969
Restricted Stock Units
Class Of Stock [Line Items]
Stock-based compensation expense	154	852	706	1,982
ESPP
Class Of Stock [Line Items]
Stock-based compensation expense	$ 5	$ 171	$ 40	$ 225

Stockholders' Equity -Schedule

Stockholders' Equity -Schedule of Fair Value of Stock Options Estimated Using Weighted-Average Assumptions (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected dividends	0%	0%	0%	0%
Expected volatility	78.10%	72.20%
Expected volatility minimum			77.40%	70.80%
Expected volatility maximum			78.10%	72.20%
Risk-free interest rate	4%	2.80%	4.20%
Risk-free interest rate minimum				1.90%
Risk-free interest rate maximum				3%
Expected term	6 years	6 years	6 years	6 years

Net Loss Per Share Attributab_3

Net Loss Per Share Attributable To Common Stockholders - Additional Information (Details)		3 Months Ended	9 Months Ended	12 Months Ended
	Feb. 07, 2023	Sep. 30, 2023	Sep. 30, 2023	Dec. 31, 2022
Earnings Per Share [Abstract]
Reverse stock split ratio	0.05	0.05	0.05	0.05

Net Loss Per Share Attributab_4

Net Loss Per Share Attributable to Common Stockholders - Schedule of Computation of Basic and Diluted Net Loss Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2023	Sep. 30, 2022
Numerator
Net loss	$ (7,181)	$ (8,681)	$ (11,343)	$ (11,329)	$ (5,613)	$ (10,925)	$ (27,205)	$ (27,867)
Denominator:
Weighted-average common stock outstanding, basic	8,872,998			1,430,056			7,805,772	1,430,272
Weighted-average common stock outstanding, diluted	8,872,998			1,430,056			7,805,772	1,430,272
Net loss per share attributable to common stockholders, basic	$ (0.81)			$ (7.92)			$ (3.49)	$ (19.48)
Net loss per share attributable to common stockholders, diluted	$ (0.81)			$ (7.92)			$ (3.49)	$ (19.48)

Net Loss Per Share Attributab_5

Net Loss Per Share Attributable to Common Stockholders - Schedule of Anti-dilutive Securities Outstanding in Common Stock Equivalent Excluded from Computation of Diluted Weighted Average Shares Outstanding (Details) - shares	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Common Stock Warrants
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount	3,888	3,888
Unvested Early Exercised Common Stock Options
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount	4,761	13,875
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	1,310,322	109,166
Unvested Restricted Stock Units
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share, amount	24,782	85,161

Subsequent Events - Additional

Subsequent Events - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions		9 Months Ended
	Sep. 28, 2023	Sep. 30, 2023	Dec. 31, 2022
Subsequent Event [Line Items]
Common stock, par value		$ 0.001	$ 0.001
New Purchase Agreement
Subsequent Event [Line Items]
Equity financing after deduction		$ 20
Accelmed Partners II LP | Private placement | New Purchase Agreement
Subsequent Event [Line Items]
Aggregate number of shares agreed to be sold	7,331,377
Common stock, par value	$ 0.001
Purchase price per share	$ 4.092