Nuwellis (NUWE) 10-Q 14 May 20 2020 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2020	May 11, 2020
Cover [Abstract]
Entity Registrant Name	CHF Solutions, Inc.
Entity Central Index Key	0001506492
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Shell Company	false
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		38,906,878
Document Type	10-Q
Amendment Flag	false
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
Entity Address, State or Province	MN

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Current assets
Cash and cash equivalents	$ 5,669	$ 1,279
Accounts receivable	727	799
Inventory	2,195	1,797
Other current assets	141	161
Total current assets	8,732	4,036
Property, plant and equipment, net	897	991
Operating lease right-of-use asset	397	442
Other assets	21	133
TOTAL ASSETS	10,047	5,602
Current liabilities
Accounts payable	787	1,488
Accrued compensation	1,114	1,592
Current portion of operating lease liability	191	186
Other current liabilities	39	85
Total current liabilities	2,131	3,351
Operating lease liability	212	261
Total liabilities	2,343	3,612
Commitments and contingencies
Stockholders' equity
Preferred stock	0	0
Common stock as of March 31, 2020 and December 31, 2019, par value $0.0001 per share; authorized 100,000,000 shares, issued and outstanding 27,142,390 and 4,674,068, respectively	3	0
Additional paid-in capital	228,560	218,278
Accumulated other comprehensive income:
Foreign currency translation adjustment	1,211	1,214
Accumulated deficit	(222,070)	(217,502)
Total stockholders' equity	7,704	1,990
TOTAL LIABILITIES AND STOCKHOLDERS' EQUITY	10,047	5,602
Series A Junior Participating Preferred Stock [Member]
Stockholders' equity
Preferred stock	0	0
Series F Convertible Preferred Stock [Member]
Stockholders' equity
Preferred stock	0	0
Series H Convertible Preferred Stock [Member]
Stockholders' equity
Preferred stock	$ 0	$ 0

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - $ / shares	Mar. 31, 2020	Dec. 31, 2019
Stockholders' equity
Preferred stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Preferred stock, shares authorized (in shares)	39,481,475	39,969,465
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common stock, shares authorized (in shares)	100,000,000	100,000,000
Common stock, shares issued (in shares)	27,142,390	4,674,068
Common stock, shares outstanding (in shares)	27,142,390	4,674,068
Series A Junior Participating Preferred Stock [Member]
Stockholders' equity
Preferred stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Preferred stock, shares authorized (in shares)	30,000	30,000
Preferred stock, shares outstanding (in shares)	0	0
Series F Convertible Preferred Stock [Member]
Stockholders' equity
Preferred stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Preferred stock, shares authorized (in shares)	435	535
Preferred stock, shares issued (in shares)	435	535
Preferred stock, shares outstanding (in shares)	435	535
Series H Convertible Preferred Stock [Member]
Stockholders' equity
Preferred stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Preferred stock, shares authorized (in shares)	488,090	0
Preferred stock, shares issued (in shares)	488,090	0
Preferred stock, shares outstanding (in shares)	488,090	0

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Consolidated Statements of Operations and Comprehensive Loss [Abstract]
Net sales	$ 1,630	$ 1,215
Costs and Expenses:
Cost of goods sold	796	612
Selling, general and administrative	4,537	4,018
Research and development	864	1,310
Total costs and expenses	6,197	5,940
Loss from operations	(4,567)	(4,725)
Other income, net	1	0
Loss before income taxes	(4,566)	(4,725)
Income tax expense	(2)	(2)
Net loss	$ (4,568)	$ (4,727)
Basic and diluted loss per share (in dollars per share)	$ (0.37)	$ (11.47)
Weighted average shares outstanding - basic and diluted (in shares)	16,439	805
Other comprehensive income:
Foreign currency translation adjustments	$ (3)	$ (2)
Total comprehensive loss	$ (4,571)	$ (4,729)

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Equity (Unaudited) - USD ($) $ in Thousands	Common Stock [Member]	Additional Paid in Capital [Member]	Accumulated Other Comprehensive Income [Member]	Accumulated Deficit [Member]	Total
Balance at Dec. 31, 2018	$ 0	$ 204,101	$ 1,223	$ (199,388)	$ 5,936
Balance (in shares) at Dec. 31, 2018	513,445
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net loss	$ 0	0	0	(4,727)	(4,727)
Foreign currency translation adjustment	0	0	(2)	0	(2)
Stock-based compensation and stock awards, net	$ 0	362	0	0	362
Stock-based compensation and stock awards, net (in shares)	3
Issuance of common and preferred stock, net	$ 0	10,959	0	0	10,959
Issuance of common and preferred stock, net (in shares)	455,178
Conversion of preferred stock into common stock	$ 0	0	0	0	0
Conversion of preferred stock into common stock (in shares)	1,100,394
Balance at Mar. 31, 2019	$ 0	215,422	1,221	(204,115)	12,528
Balance (in shares) at Mar. 31, 2019	2,069,020
Balance at Dec. 31, 2018	$ 0	204,101	1,223	(199,388)	5,936
Balance (in shares) at Dec. 31, 2018	513,445
Balance at Dec. 31, 2019	$ 0	218,278	1,214	(217,502)	1,990
Balance (in shares) at Dec. 31, 2019	4,674,068
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net loss	$ 0	0	0	(4,568)	(4,568)
Foreign currency translation adjustment	0	0	(3)	0	(3)
Stock-based compensation and stock awards, net	$ 0	380	0	0	380
Stock-based compensation and stock awards, net (in shares)	0
Issuance of common and preferred stock, net	$ 3	9,613	0	0	9,616
Issuance of common and preferred stock, net (in shares)	10,207,759
Exercise of warrants	$ 0	289	0	0	289
Exercise of warrants (in shares)	898,050
Conversion of preferred stock into common stock	$ 0	0	0	0	0
Conversion of preferred stock into common stock (in shares)	11,362,513
Balance at Mar. 31, 2020	$ 3	$ 228,560	$ 1,211	$ (222,070)	$ 7,704
Balance (in shares) at Mar. 31, 2020	27,142,390

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Operating Activities:
Net loss	$ (4,568)	$ (4,727)
Adjustments to reconcile net loss to cash flows used in operating activities:
Depreciation and amortization	65	59
Stock-based compensation expense, net	380	362
Loss on disposal of property and equipment	46	0
Changes in operating assets and liabilities:
Accounts receivable	72	164
Inventory	(398)	(132)
Other current assets	20	(147)
Other assets and liabilities	67	112
Accounts payable and accrued expenses	(1,179)	(598)
Net cash used in operating activities	(5,495)	(4,907)
Investing Activities:
Purchase of property and equipment	(17)	(41)
Net cash used in investing activities	(17)	(41)
Financing Activities:
Proceeds from public stock offerings, net	9,616	10,959
Proceeds from warrant exercises	289	0
Net cash provided by financing activities	9,905	10,959
Effect of exchange rate changes on cash	(3)	(2)
Net increase (decrease) in cash and cash equivalents	4,390	6,009
Cash and cash equivalents - beginning of period	1,279	5,480
Cash and cash equivalents - end of period	5,669	11,489
Supplemental cash flow information
Cash paid for income taxes	$ 0	$ 0

Nature of Business and Basis of

Nature of Business and Basis of Presentation	3 Months Ended
	Mar. 31, 2020
Nature of Business and Basis of Presentation [Abstract]
Nature of Business and Basis of Presentation	Note 1 – Nature of Business and Basis of Presentation Nature of Business : The Aquadex SmartFlow system is indicated for temporary (up to eight hours) or extended (longer than 8 hours in patients who require hospitalization) use in adult and pediatric patients weighing 20kg or more whose fluid overload is unresponsive to medical management, including diuretics Previously, the Company was focused on developing the C-Pulse® Heart Assist System for treatment of Class III and ambulatory Class IV heart failure. In August 2016, the Company acquired the business associated with the Aquadex FlexFlow system (herein referred to as the “Aquadex Business”) from a subsidiary of Baxter International, Inc. (“Baxter”), and refocused its strategy to fully devote its resources to the Aquadex Business. Principles of Consolidation: For further information, refer to the consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2019. Going Concern: The Company became a revenue generating company after acquiring the Aquadex Business in August 2016. The Company expects to incur additional losses in the near-term as it grows the Aquadex Business, including investments in expanding its sales and marketing capabilities, purchasing inventory, manufacturing components, and complying with the requirements related to being a U.S. public company. To become and remain profitable, the Company must succeed in expanding the adoption and market acceptance of the Aquadex FlexFlow. This will require the Company to succeed in training personnel at hospitals and effectively and in efficiently manufacturing, marketing and distributing the Aquadex FlexFlow and related components. There can be no assurance that the Company will succeed in these activities, and it may never generate revenues sufficient to achieve profitability. During 2018, 2019 and through May 5, 2020, the Company closed on underwritten public and other equity offerings for aggregate net proceeds of approximately $30.3 million after deducting the underwriting discounts and commissions or placement agents fees and offering expenses, as applicable, and other costs associated with the offerings (see Note 4 –Shareholder’s Equity). The Company will require additional funding to grow its Aquadex Business, which may not be available on terms favorable to the Company, or at all. The Company may receive those funds from the proceeds from future warrant exercises, issuances of equity securities, or other financing transactions. Should warrant exercises not materialize or future capital raising be unsuccessful, the Company may not be able to continue as a going concern. No adjustments have been made relating to the recoverability and classification of recorded asset amounts and classification of liabilities that might be necessary should the Company not continue as a going concern. Revenue Recognition: Revenue from Contracts with Customers Accounts Receivable Inventories ( in thousands) March 31, 2020 December 31, 2019 Finished Goods $ 882 $ 750 Work in Process 221 79 Raw Materials 1,092 968 Total $ 2,195 $ 1,797 Loss per share: Diluted earnings per share is computed based on the net loss allocable to common stockholders for each period divided by the weighted average number of common shares outstanding, increased by the number of additional shares that would have been outstanding had the potentially dilutive common shares been issued, and reduced by the number of shares the Company could have repurchased from the proceeds from issuance of the potentially dilutive shares. Potentially dilutive shares of common stock include shares underlying outstanding convertible preferred stock, warrants, stock options and other stock-based awards granted under stock-based compensation plans. The following table sets forth the potential shares of common stock that are not included in the calculation of diluted net loss per share because to do so would be anti-dilutive as of the end of each period presented: March 31 2020 2019 Warrants to purchase common stock 27,775,444 5,330,721 Series H convertible preferred stock 488,090 — Series G convertible preferred stock — 810,142 Series F convertible preferred stock 1,450,290 102,185 Stock options 421,062 138,104 Total 30,134,886 6,381,152 The following table reconciles reported net loss with reported net loss per share for each of the three months ended March 31: (in thousands, except per share amounts) 2020 2019 Net loss $ (4,568 ) $ (4,727 ) Deemed dividend to preferred shareholders (see Note 4) (1,588 ) (4,508 ) Net loss after deemed dividend (6,156 ) (9,235 ) Weighted average shares outstanding 16,439 805 Basic and diluted loss per share $ (0.37 ) $ (11.47 ) The Company evaluates events through the date the consolidated financial statements are filed for events requiring adjustment to or disclosure in the consolidated financial statements.

Revenue Recognition

Revenue Recognition	3 Months Ended
	Mar. 31, 2020
Revenue Recognition [Abstract]
Revenue Recognition	Note 2 – Revenue Recognition Net Sales The Company sells its products in the United States primarily through a direct sales force. Customers who purchase the Company’s products include hospitals and clinics throughout the United States. In countries outside the United States, the Company sells its products through a limited number of specialty healthcare distributors in the United Kingdom, Italy, Spain, Germany, Austria, Switzerland, Southeast Asia, Brazil, India, Greece and the United Arab Emirates. These distributors resell the Company’s products to hospitals and clinics in their respective geographies. Revenue from product sales are recognized when the customer or distributor obtains control of the product, which occurs at a point in time, most frequently upon shipment of the product or receipt of the product, depending on shipment terms. The Company’s standard shipping terms are FOB shipping point, unless the customer requests that control and title to the inventory transfer upon delivery. Revenue is measured as the amount of consideration we expect to receive, adjusted for any applicable estimates of variable consideration and other factors affecting the transaction price, which is based on the invoiced price, in exchange for transferring products. All revenue is recognized when the Company satisfies its performance obligations under the contract. The majority of the Company’s contracts have a single performance obligation and are short term in nature. The Company has entered into extended service plans with customers which are recognized over time. This revenue represents less than 1% of net sales for the three months ended March 31, 2020 and 2019. The unfulfilled performance obligations related to these extended service plans is included in deferred revenue, which is included in other current liabilities on the consolidated balance sheets. The majority of the deferred revenue is expected to be recognized within one year. Sales taxes and value added taxes in foreign jurisdictions that are collected from customers and remitted to governmental authorities are accounted for on a net basis and therefore are excluded from net sales. Revenue includes shipment and handling fees charged to customers. Shipping and handling costs associated with outbound freight after control over a product has transferred to a customer are accounted for as a fulfillment cost and are included in cost of goods sold. Product Returns: The Company offers customers a limited right of return for its product in case of non-conformity or performance issues. The Company estimates the amount of its product sales that may be returned by its customers and records this estimate as a reduction of revenue in the period the related product revenue is recognized. The Company currently estimates product return liabilities using available industry data and its own historical sales and returns information. The Company has not received any returns to date and believes that future returns of its products will be minimal. Therefore, revenue recognized is not currently impacted by variable consideration related to product returns.

Debt

Debt	3 Months Ended
	Mar. 31, 2020
Debt [Abstract]
Debt	Note 3 - Debt On August 5, 2016, the Company entered into a loan and security agreement with Silicon Valley Bank (the “Bank”). Under this agreement, the Bank agreed to provide the Company with up to $5.0 million in debt financing, consisting of a term loan in an aggregate original principal amount not to exceed $4.0 million (the “Term Loan”) and a revolving line of credit in an aggregate principal amount not to exceed $1.0 million outstanding at any time (the “Revolving Line”). Proceeds from the loans were to be used for general corporate and working capital purposes. Advances under the Term Loan were available to the Company until November 30, 2016 and were subject to the Company’s compliance with liquidity covenants. The Term Loan expired unused on November 30, 2016 and the Term Loan is no longer available to be drawn. Advances under the Revolving Line were available to the Company until March 31, 2020 and were to accrue interest at a floating annual rate equal to 1.75% or 1.0% above the prime rate, depending on liquidity factors. Outstanding borrowings, if any, were to be collateralized by all of the Company’s assets, excluding intellectual property which is subject to a negative pledge. There were no borrowings outstanding under this facility as of March 31, 2020 or December 31, 2019. The Revolving Line expired unused on March 31, 2020.

Shareholder's Equity

Shareholder's Equity	3 Months Ended
	Mar. 31, 2020
Shareholder's Equity [Abstract]
Shareholder's Equity	Note 4 – Shareholder’s Equity Series F Convertible Preferred Stock The offering was comprised of Series F convertible preferred stock, convertible into shares of the Company’s common stock at an initial conversion price of $63.00 per share. Each share of Series F convertible preferred stock was accompanied by a Series 1 warrant, which was to expire on the first anniversary of its issuance, to purchase 16 shares of the Company’s common stock at an exercise price of $63.00 per share, and a Series 2 warrant, which expires on the seventh anniversary of its issuance, to purchase 16 shares of the Company’s common stock at an exercise price of $63.00 per share. The Series F convertible preferred stock has full ratchet price based anti-dilution protection, subject to customary carve outs, in the event of a down-round financing at a price per share below the conversion price of the Series F convertible preferred stock (which protection will expire if, during any 20 of 30 consecutive trading days, the volume weighted average price of the Company’s common stock exceeds 300% of the then-effective conversion price of the Series F convertible preferred stock and the daily dollar trading volume for each trading day during such period exceeds $200,000). The exercise price of the warrants is fixed and does not contain any variable pricing features, nor any price based anti-dilutive features, apart from customary adjustments for stock splits, combinations, reclassifications, stock dividends or fundamental transactions. A total of 18,000 shares of Series F convertible preferred stock initially convertible into 286,714 shares of common stock and warrants to purchase 573,310 shares of common stock were issued in the offering. Effective July 3, 2018, the conversion price of the Series F convertible preferred stock was reduced from $63.00 to $29.68, the per share price in the July 2018 Offering described below. Effective March 12, 2019, the conversion price of the Series F convertible preferred stock was reduced from $29.68 to $5.25, the per share price to the public of the Series G convertible preferred stock which closed in an underwritten public offering on March 12, 2019. Effective October 25, 2019, the conversion price of the Series F convertible preferred stock was reduced from $5.25 to $1.41, and on November 6, 2019 from $1.41 to $0.9942, the per share price to the public in the October and November 2019 transactions, respectively, described below. Effective January 28, 2020, the conversion price of the Series F convertible preferred stock was reduced from $0.9942 to $0.55, the per share price to the public of the Series H convertible preferred stock which closed in an underwritten public offering on January 28, 2020. Effective March 23, 2020, the conversion price of the Series F convertible preferred stock was reduced from $0.55 to $0.30, the per share price to the public in the March 2020 transaction, described below. As of March 31, 2020, and December 31,2019, 435 and 535 shares of the Series F convertible preferred stock remained outstanding, respectively. July 2018 Offering: On July 3, 2018, the Company closed on an underwritten public offering of 181,941 shares of its common stock at a public offering price of $29.68 per share, for gross proceeds of $5.4 million, including the full exercise of the underwriters’ over-allotment option to purchase additional shares of the Company’s common stock (the “July 2018 Offering”). deducting underwriting discounts and commissions and offering expenses. In connection with the July 2018 Offering, and to induce certain institutional investors who hold warrants issued by the Company in November 2017 (“November 2017 Warrants”) to participate in the July 2018 Offering, the Company entered into letter agreements with such institutional investors. Pursuant to the terms of these agreements, the Company agreed, effective July 3, 2018, to reduce the per share exercise price of the November 2017 Warrants held by such institutional investors to $29.68 and to extend the expiration date of the warrants that were to expire on November 27, 2018 to November 27, 2019. The number of common shares underlying the warrants that were repriced did not change. The repriced warrants were exercisable for 554,322 shares of common stock in the aggregate, of which, following such amendment, half expired on November 27, 2019 and half will expire on November 27, 2024. The repricing of the warrants was accounted as an equity financing cost, with no impact to net proceeds from the offering. Series G Convertible Preferred Stock and March 2019 Offering The March 2019 Offering was comprised of 455,178 shares of common stock priced at $5.25 per share and 1,910,536 shares of Series G convertible preferred stock, convertible into common stock at $5.25 per share. Each share of Series G convertible preferred stock and each share of common stock was accompanied by a Series 1 warrant and a Series 2 warrant. The Series 1 warrants are exercisable into 2,365,714 shares of common stock and the Series 2 warrants are exercisable into 2,365,714 shares of common stock. Series 1 warrants expire on the fifth anniversary of the date of issuance and are exercisable at $5.25 to purchase one share of common stock. Series 2 warrants expire on the earlier of: (i) the eighteen-month anniversary of the date of issuance and (ii) the 30th trading day following the public announcement of the receipt from the U.S. Food and Drug Administration (FDA) of clearance or approval of a modification to the product label for the Aquadex System to include pediatric patients. Series 2 warrants are exercisable at $5.25 per share of common stock. The Company announced it had received FDA clearance for use of its Aquadex System in pediatric patients on February 26, 2020, effectively setting the date of expiration of these warrants for April 8, 2020. As of March 31, 2020, and December 31, 2019, all 1,910,536 shares of the Series G convertible preferred stock had been converted into common stock and none remained outstanding. October and November 2019 Offerings On October 25, 2019, the Company closed on a registered direct offering of 575,830 shares of common stock at a price of $1.15 per share, for gross proceeds of approximately $660,000, prior to deducting commissions and expenses related to the transaction. In a concurrent private placement, the Company agreed to issue to the investors in the registered direct offering unregistered warrants to purchase up to 575,830 shares of its common stock at an exercise price of $1.41 per share, which will be exercisable six months from the date of issuance, and will expire five years from the initial exercise date. On November 6, 2019, the Company closed on a registered direct offering of 1,219,076 shares of common stock, or common equivalents, at a price of $1.12 per share, for gross proceeds of approximately $1.36 million prior to deduction of commissions and offering expenses related to the transaction. In a concurrent private placement, the Company agreed to issue to the investors in the registered direct offering unregistered warrants to purchase up to 1,219,076 shares of our common stock at an exercise price of $0.9942 per share, which were exercisable upon the date of issuance, and will expire five years from the initial exercise date. The unregistered warrants issued in each offering were subsequently registered pursuant to a registration statement on Form S-1 that was declared effective by the SEC on December 30, 2019. Series H Convertible Preferred Stock and January 2020 Offering: The January 2020 Offering was comprised of 6,046,367 shares of common stock priced at $0.55 per share and 11,517,269 shares of Series H convertible preferred stock, convertible into common stock at $0.55 per share, . Each share of Series H convertible preferred stock and each share of common stock was accompanied by a warrant to purchase common stock. The warrants are exercisable into 17,563,636 shares of common stock. As of March 31, 2020, 11,029,179 shares of the Series H convertible preferred stock had been converted into common stock and 488,090 shares remained outstanding. March 2020 Offering: The warrants to purchase up to 4,161,392 shares of common stock have an exercise price of $0.3726 per share, will be exercisable six months from the date of issuance, and will expire five and a half years from the date of issuance. On April 29, 2020, the Company filed a registration statement to register the shares of common stock issuable upon exercise of the warrants. The registration statement was declared effective by the SEC on May 8, 2020 . Placement Agent Fees Market-Based Warrants

Stock-Based Compensation

Stock-Based Compensation	3 Months Ended
	Mar. 31, 2020
Stock-Based Compensation [Abstract]
Stock-Based Compensation	Note 5 - Stock-Based Compensation Under the fair value recognition provisions of U.S. GAAP for accounting for stock-based compensation, the Company measures stock-based compensation expense at the grant date based on the fair value of the award and recognizes the compensation expense over the requisite service period, which is generally the vesting period. The following table presents the classification of stock-based compensation expense recognized for the periods below: Three-months ended March 31, (in thousands) 2020 2019 Selling, general and administrative expense $ 354 $ 326 Research and development expense 26 36 Total stock-based compensation expense $ 380 $ 362

Fair Value of Financial Instrum

Fair Value of Financial Instruments	3 Months Ended
	Mar. 31, 2020
Fair Value of Financial Instruments [Abstract]
Fair Value of Financial Instruments	Note 6 - Fair Value of Financial Instruments The Company’s financial instruments consist of cash and cash equivalents and warrants. The Company’s financial assets and liabilities are measured at fair value on a recurring basis and are classified and disclosed in one of the following three categories: • Level 1 • Level 2 • Level 3 The fair value of the market-based warrants described in Note 4 was calculated using a Monte Carlo valuation model and was classified as Level 3 in the fair value hierarchy. These warrants are classified as permanent equity and as a result, were measured at the grant date and are not required to be remeasured to fair value at each reporting period end. All cash equivalents are considered Level 1 measurements for all periods presented. The Company does not have any financial instruments classified as Level 2 or Level 3 and there were no movements between these categories as of March 31, 2020 and December 31, 2019. The Company believes that the carrying amounts of all remaining financial instruments approximate their fair value due to their relatively short maturities.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2020
Income Taxes [Abstract]
Income Taxes	Note 7 – Income Taxes The Company provides for a valuation allowance when it is more likely than not that it will not realize a portion of the deferred tax assets. The Company has established a full valuation allowance for U.S. and foreign deferred tax assets due to the uncertainty that enough taxable income will be generated in those taxing jurisdictions to utilize the assets. Therefore, the Company has not reflected any benefit of such deferred tax assets in the accompanying condensed consolidated financial statements. As of March 31, 2020, there were no material changes to what the Company disclosed regarding tax uncertainties or penalties in its Annual Report on Form 10-K for the year ended December 31, 2019.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2020
Commitments and Contingencies [Abstract]
Commitments and Contingencies	Note 8—Commitments and Contingencies Employee Retirement Plan:

Subsequent Events

Subsequent Events	3 Months Ended
	Mar. 31, 2020
Subsequent Events [Abstract]
Subsequent Events	Note 9—Subsequent Events April 2020 Transaction : On April 1, 2020 the Company closed on a registered direct offering of 5,130,228 shares of its common stock at a price to the public of per share, for gross proceeds of approximately , prior to deduction of commissions and offering related to the transaction. In a concurrent private placement, the Company agreed to issue to the investors in the registered direct offering unregistered warrants to purchase up to 2,565,114 shares of the Company’s common stock. The warrants have an exercise price of $0.3715 per share, are exercisable immediately, and will expire five and a half years from the date of issuance. On April 29, 2020, the Company filed a registration statement to register the shares of common stock issuable upon exercise of these warrants and the warrants issued in the March 2020 transaction. The registration statement was declared effective by the SEC on May 8, 2020 . Paycheck Protection Program: On April 21, 2020, the Company announced it had received of $1.66 million under the Paycheck Protection Program (PPP) under the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act. Subsequent to the Company applying and receiving the funds under the PPP, the United States Treasury Department and the U.S. Small Business Administration issued new guidance regarding eligibility for these loans. As a result, on May 12, 2020, the Company announced it had elected to return all funds it had received under the PPP, so that these funds could be used to help another small business in greater need during the COVID-19 pandemic May 2020 Transaction : On May 5, 2020 the Company closed on a registered direct offering of 3,597,880 shares of its common stock at a price to the public of $0.4725 per share, for gross proceeds of approximately $1.7 , prior to deduction of commissions and offering related to the transaction. In a concurrent private placement, the Company agreed to issue to the investors in the registered direct offering unregistered warrants to purchase up to 1,798,940 shares of the Company’s common stock. The warrants have an exercise price of $0.41 per share, are exercisable immediately, and will expire five and a half years from the date of issuance. Warrant Exercises : The Company announced that, during the months of April and May 2020, it had received cash proceeds of approximately $1.0 million, resulting from the exercise of warrants to purchase approximately 3.0 million shares of its common stock

Nature of Business and Basis _2

Nature of Business and Basis of Presentation (Policies)	3 Months Ended
	Mar. 31, 2020
Nature of Business and Basis of Presentation [Abstract]
Principles of Consolidation	Principles of Consolidation: For further information, refer to the consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2019.
Going Concern	Going Concern: The Company became a revenue generating company after acquiring the Aquadex Business in August 2016. The Company expects to incur additional losses in the near-term as it grows the Aquadex Business, including investments in expanding its sales and marketing capabilities, purchasing inventory, manufacturing components, and complying with the requirements related to being a U.S. public company. To become and remain profitable, the Company must succeed in expanding the adoption and market acceptance of the Aquadex FlexFlow. This will require the Company to succeed in training personnel at hospitals and effectively and in efficiently manufacturing, marketing and distributing the Aquadex FlexFlow and related components. There can be no assurance that the Company will succeed in these activities, and it may never generate revenues sufficient to achieve profitability. During 2018, 2019 and through May 5, 2020, the Company closed on underwritten public and other equity offerings for aggregate net proceeds of approximately $30.3 million after deducting the underwriting discounts and commissions or placement agents fees and offering expenses, as applicable, and other costs associated with the offerings (see Note 4 –Shareholder’s Equity). The Company will require additional funding to grow its Aquadex Business, which may not be available on terms favorable to the Company, or at all. The Company may receive those funds from the proceeds from future warrant exercises, issuances of equity securities, or other financing transactions. Should warrant exercises not materialize or future capital raising be unsuccessful, the Company may not be able to continue as a going concern. No adjustments have been made relating to the recoverability and classification of recorded asset amounts and classification of liabilities that might be necessary should the Company not continue as a going concern.
Revenue Recognition	Revenue Recognition: Revenue from Contracts with Customers
Accounts Receivable	Accounts Receivable
Inventories	Inventories ( in thousands) March 31, 2020 December 31, 2019 Finished Goods $ 882 $ 750 Work in Process 221 79 Raw Materials 1,092 968 Total $ 2,195 $ 1,797
Loss per Share	Loss per share: Diluted earnings per share is computed based on the net loss allocable to common stockholders for each period divided by the weighted average number of common shares outstanding, increased by the number of additional shares that would have been outstanding had the potentially dilutive common shares been issued, and reduced by the number of shares the Company could have repurchased from the proceeds from issuance of the potentially dilutive shares. Potentially dilutive shares of common stock include shares underlying outstanding convertible preferred stock, warrants, stock options and other stock-based awards granted under stock-based compensation plans. The following table sets forth the potential shares of common stock that are not included in the calculation of diluted net loss per share because to do so would be anti-dilutive as of the end of each period presented: March 31 2020 2019 Warrants to purchase common stock 27,775,444 5,330,721 Series H convertible preferred stock 488,090 — Series G convertible preferred stock — 810,142 Series F convertible preferred stock 1,450,290 102,185 Stock options 421,062 138,104 Total 30,134,886 6,381,152 The following table reconciles reported net loss with reported net loss per share for each of the three months ended March 31: (in thousands, except per share amounts) 2020 2019 Net loss $ (4,568 ) $ (4,727 ) Deemed dividend to preferred shareholders (see Note 4) (1,588 ) (4,508 ) Net loss after deemed dividend (6,156 ) (9,235 ) Weighted average shares outstanding 16,439 805 Basic and diluted loss per share $ (0.37 ) $ (11.47 ) The Company evaluates events through the date the consolidated financial statements are filed for events requiring adjustment to or disclosure in the consolidated financial statements.

Nature of Business and Basis _3

Nature of Business and Basis of Presentation (Tables)	3 Months Ended
	Mar. 31, 2020
Nature of Business and Basis of Presentation [Abstract]
Inventories	Inventories consisted of the following: ( in thousands) March 31, 2020 December 31, 2019 Finished Goods $ 882 $ 750 Work in Process 221 79 Raw Materials 1,092 968 Total $ 2,195 $ 1,797
Potential Shares of Common Stock not Included in Diluted Net Loss Per Share	The following table sets forth the potential shares of common stock that are not included in the calculation of diluted net loss per share because to do so would be anti-dilutive as of the end of each period presented: March 31 2020 2019 Warrants to purchase common stock 27,775,444 5,330,721 Series H convertible preferred stock 488,090 — Series G convertible preferred stock — 810,142 Series F convertible preferred stock 1,450,290 102,185 Stock options 421,062 138,104 Total 30,134,886 6,381,152
Reconciliation of Reported Net Loss with Reported Net Loss Per Share	The following table reconciles reported net loss with reported net loss per share for each of the three months ended March 31: (in thousands, except per share amounts) 2020 2019 Net loss $ (4,568 ) $ (4,727 ) Deemed dividend to preferred shareholders (see Note 4) (1,588 ) (4,508 ) Net loss after deemed dividend (6,156 ) (9,235 ) Weighted average shares outstanding 16,439 805 Basic and diluted loss per share $ (0.37 ) $ (11.47 )

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2020
Stock-Based Compensation [Abstract]
Classification of Stock-Based Compensation Expense	The following table presents the classification of stock-based compensation expense recognized for the periods below: Three-months ended March 31, (in thousands) 2020 2019 Selling, general and administrative expense $ 354 $ 326 Research and development expense 26 36 Total stock-based compensation expense $ 380 $ 362

Nature of Business and Basis _4

Nature of Business and Basis of Presentation, Nature of Business, Going Concern, Accounts Receivable and Inventories (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended	28 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019	May 05, 2020
Going Concern [Abstract]
Accumulated deficit	$ (222,070)		$ (217,502)
Accounts Receivable [Abstract]
Accounts receivables maximum credit period from invoice date	30 days
Allowance for doubtful accounts	$ 0		0
Inventories [Abstract]
Finished Goods	882		750
Work in Process	221		79
Raw Materials	1,092		968
Total	$ 2,195		$ 1,797
Subsequent Event [Member]
Going Concern [Abstract]
Net proceeds from issuance of convertible preferred stock				$ 30,300
Customer One [Member] | Accounts Receivable [Member]
Revenue, Performance Obligation [Abstract]
Concentration risk percentage	23.00%		13.00%
Customer Two [Member] | Accounts Receivable [Member]
Revenue, Performance Obligation [Abstract]
Concentration risk percentage	18.00%		12.00%
ASC 606 [Member] | Customer One [Member] | Net Sales [Member]
Revenue, Performance Obligation [Abstract]
Concentration risk percentage	15.00%	12.00%
ASC 606 [Member] | Customer Two [Member] | Net Sales [Member]
Revenue, Performance Obligation [Abstract]
Concentration risk percentage	13.00%
ASC 606 [Member] | Customer Three [Member] | Net Sales [Member]
Revenue, Performance Obligation [Abstract]
Concentration risk percentage	10.00%

Nature of Business and Basis _5

Nature of Business and Basis of Presentation, Loss Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Potential shares of common stock that are not included in the calculation of diluted net loss per share [Abstract]
Potential shares of common stock that are not included in the calculation of diluted net loss per share (in shares)	30,134,886	6,381,152
Reported net loss with reported net loss per share [Abstract]
Net loss	$ (4,568)	$ (4,727)
Deemed dividend to preferred shareholders (see Note 4)	(1,588)	(4,508)
Net loss after deemed dividend	$ (6,156)	$ (9,235)
Weighted average shares outstanding (in shares)	16,439,000	805,000
Basic and diluted loss per share (in dollars per share)	$ (0.37)	$ (11.47)
Warrants to Purchase Common Stock [Member]
Potential shares of common stock that are not included in the calculation of diluted net loss per share [Abstract]
Potential shares of common stock that are not included in the calculation of diluted net loss per share (in shares)	27,775,444	5,330,721
Series H Preferred Stock [Member]
Potential shares of common stock that are not included in the calculation of diluted net loss per share [Abstract]
Potential shares of common stock that are not included in the calculation of diluted net loss per share (in shares)	488,090	0
Series G Preferred Stock [Member]
Potential shares of common stock that are not included in the calculation of diluted net loss per share [Abstract]
Potential shares of common stock that are not included in the calculation of diluted net loss per share (in shares)	0	810,142
Series F Convertible Preferred Stock [Member]
Potential shares of common stock that are not included in the calculation of diluted net loss per share [Abstract]
Potential shares of common stock that are not included in the calculation of diluted net loss per share (in shares)	1,450,290	102,185
Stock Options [Member]
Potential shares of common stock that are not included in the calculation of diluted net loss per share [Abstract]
Potential shares of common stock that are not included in the calculation of diluted net loss per share (in shares)	421,062	138,104

Revenue Recognition (Details)

Revenue Recognition (Details)	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2020-01-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Abstract]
Expected timing of satisfaction, period	1 year
Sales Revenue [Member] | ASC 606 [Member] | Maximum [Member]
Revenue, Performance Obligation [Abstract]
Percentage of net sales	1.00%	1.00%

Debt (Details)

Debt (Details) - Silicon Valley Bank [Member] - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Dec. 31, 2019	Aug. 05, 2016
Line of Credit Facility [Abstract]
Maximum borrowing capacity	$ 5,000
Term Loan [Member]
Line of Credit Facility [Abstract]
Maximum borrowing capacity			$ 4,000
Maturity date	Nov. 30, 2016
Revolving Line [Member]
Line of Credit Facility [Abstract]
Maximum borrowing capacity	$ 1,000
Maturity date	Mar. 31, 2020
Total borrowings outstanding	$ 0	$ 0
Revolving Line [Member] | Floating Annual Rate [Member]
Line of Credit Facility [Abstract]
Interest rate	1.75%
Revolving Line [Member] | Prime Rate [Member]
Line of Credit Facility [Abstract]
Interest rate	1.00%

Shareholder's Equity (Details)

Shareholder's Equity (Details) $ / shares in Units, $ in Thousands	Mar. 23, 2020USD ($)$ / sharesshares	Jan. 28, 2020USD ($)$ / sharesshares	Nov. 06, 2019USD ($)$ / sharesshares	Oct. 25, 2019USD ($)$ / sharesshares	Mar. 12, 2019USD ($)$ / sharesshares	Jul. 03, 2018USD ($)$ / sharesshares	Nov. 27, 2017USD ($)$ / sharesshares	Mar. 31, 2020USD ($)$ / sharesshares	Dec. 31, 2019shares	May 30, 2019$ / sharesshares
Class of Stock Disclosures [Abstract]
Warrants to purchase shares of common stock (in shares)		17,563,636	1,219,076	575,830
Exercise price of warrants (in dollars per share) | $ / shares	$ 0.3726	$ 0.55	$ 0.9942	$ 1.41
Preferred stock, shares outstanding (in shares)								0	0
Issuance of common stock, net (in shares)		6,046,367	1,219,076	575,830
Public offering price (in dollars per share) | $ / shares			$ 1.12	$ 1.15
Gross proceeds from public stock offering | $		$ 9,700	$ 1,360	$ 660
Net proceeds from public stock offering | $		8,600
Beneficial conversion amount | $		$ 1,600
Warrant expiry period	5 years 7 months 6 days		5 years	5 years
Warrants exercisable period	6 months			6 months
Expected Stock Price Volatility [Member]
Class of Stock Disclosures [Abstract]
Warrants measurement input								1.3621
July 2018 Offering [Member]
Class of Stock Disclosures [Abstract]
Issuance of common stock, net (in shares)						181,941
Public offering price (in dollars per share) | $ / shares						$ 29.68
Gross proceeds from public stock offering | $						$ 5,400
Net proceeds from public stock offering | $						$ 4,600
Number of shares issuable on the exercise of warrants (in shares)						554,322
March 2019 Offering [Member]
Class of Stock Disclosures [Abstract]
Issuance of common stock, net (in shares)					455,178
Public offering price (in dollars per share) | $ / shares					$ 5.25
March 2020 Offering [Member]
Class of Stock Disclosures [Abstract]
Warrants to purchase shares of common stock (in shares)	4,161,392
Exercise price of warrants (in dollars per share) | $ / shares	$ 0.30
Issuance of common stock, net (in shares)	4,161,392
Public offering price (in dollars per share) | $ / shares	$ 0.30
Gross proceeds from public stock offering | $	$ 1,200
Net proceeds from public stock offering | $	$ 1,000
Warrants [Member]
Class of Stock Disclosures [Abstract]
Number of warrants vested (in shares)								0
Warrants [Member] | Consultant [Member]
Class of Stock Disclosures [Abstract]
Warrants to purchase shares of common stock (in shares)										100,000
Exercise price of warrants (in dollars per share) | $ / shares								$ 1.93		$ 3.18
Series F Convertible Preferred Stock [Member]
Class of Stock Disclosures [Abstract]
Gross proceeds from issuance of convertible preferred stock | $							$ 18,000
Net proceeds from issuance of convertible preferred stock | $							$ 16,200
Conversion price (in dollars per share) | $ / shares	$ 0.30	$ 0.55	$ 0.9942	$ 1.41	$ 5.25	$ 29.68	$ 63
Number of consecutive trading days considered for expiration								20 days
Number of consecutive trading days								30 days
Preferred stock issued (in shares)							18,000	435	535
Number of shares issuable on conversion of preferred stock (in shares)							286,714
Preferred stock, shares outstanding (in shares)								435	535
Aggregate cash placement fee					8.00%
Series F Convertible Preferred Stock [Member] | Minimum [Member]
Class of Stock Disclosures [Abstract]
Percentage of volume weighted average price of common stock							300.00%
Trading volume for each trading day | $							$ 200
Series F Convertible Preferred Stock [Member] | Warrants [Member]
Class of Stock Disclosures [Abstract]
Warrants to purchase shares of common stock (in shares)							573,310
Series F Convertible Preferred Stock [Member] | Warrant Series 1 [Member]
Class of Stock Disclosures [Abstract]
Warrants to purchase shares of common stock (in shares)							16
Exercise price of warrants (in dollars per share) | $ / shares						29.68	$ 63
Series F Convertible Preferred Stock [Member] | Warrant Series 2 [Member]
Class of Stock Disclosures [Abstract]
Warrants to purchase shares of common stock (in shares)							16
Exercise price of warrants (in dollars per share) | $ / shares						$ 29.68	$ 63
Series G Convertible Preferred Stock [Member]
Class of Stock Disclosures [Abstract]
Gross proceeds from issuance of convertible preferred stock | $					$ 12,400
Net proceeds from issuance of convertible preferred stock | $					$ 11,000
Conversion price (in dollars per share) | $ / shares					$ 5.25
Number of consecutive trading days								30 days
Preferred stock, shares outstanding (in shares)								0
Beneficial conversion amount | $								$ 4,500
Beneficial ownership limitation					4.99%
Conversion of preferred stock into common stock (in shares)								1,910,536	1,910,536
Series G Convertible Preferred Stock [Member] | March 2019 Offering [Member]
Class of Stock Disclosures [Abstract]
Number of shares issuable on conversion of preferred stock (in shares)					1,910,536
Series G Convertible Preferred Stock [Member] | Warrant Series 1 [Member]
Class of Stock Disclosures [Abstract]
Exercise price of warrants (in dollars per share) | $ / shares					$ 5.25
Number of shares issuable on the exercise of warrants (in shares)					2,365,714
Series G Convertible Preferred Stock [Member] | Warrant Series 2 [Member]
Class of Stock Disclosures [Abstract]
Exercise price of warrants (in dollars per share) | $ / shares					$ 5.25
Number of shares issuable on the exercise of warrants (in shares)					2,365,714
Series H Preferred Stock [Member]
Class of Stock Disclosures [Abstract]
Conversion price (in dollars per share) | $ / shares		$ 0.55
Preferred stock issued (in shares)								488,090	0
Preferred stock, shares outstanding (in shares)								488,090	0
Issuance of common stock, net (in shares)		11,517,269
Public offering price (in dollars per share) | $ / shares		$ 0.55
Maximum percentage of the applicable Unit offering price, by which exercise price can be lower than adjustment		10.00%
Conversion of preferred stock into common stock (in shares)								11,029,179

Stock-Based Compensation (Detai

Stock-Based Compensation (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Stock-Based Compensation Expense Items [Abstract]
Stock-based compensation expense	$ 380	$ 362
Selling, General and Administrative Expense [Member]
Stock-Based Compensation Expense Items [Abstract]
Stock-based compensation expense	354	326
Research and Development Expense [Member]
Stock-Based Compensation Expense Items [Abstract]
Stock-based compensation expense	$ 26	$ 36

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Fair Value Transfers between levels [Abstract]
Level 1 to Level 2 asset transfers	$ 0	$ 0
Level 2 to Level 1 asset transfers	0	0
Level 1 to Level 2 liability transfers	0	0
Level 2 to Level 1 liability transfers	$ 0	$ 0

Subsequent Events (Details)

Subsequent Events (Details) - USD ($) $ / shares in Units, $ in Thousands	May 05, 2020	Apr. 01, 2020	Mar. 23, 2020	Jan. 28, 2020	Nov. 06, 2019	Oct. 25, 2019	May 14, 2020	Mar. 31, 2020	Mar. 31, 2019	Apr. 21, 2020
Subsequent Events [Abstract]
Issuance of common stock, net (in shares)				6,046,367	1,219,076	575,830
Public offering price (in dollars per share)					$ 1.12	$ 1.15
Gross proceeds from public stock offering				$ 9,700	$ 1,360	$ 660
Warrants to purchase shares of common stock (in shares)				17,563,636	1,219,076	575,830
Exercise price of warrants (in dollars per share)			$ 0.3726	$ 0.55	$ 0.9942	$ 1.41
Warrants exercisable period			6 months			6 months
Warrant expiry period			5 years 7 months 6 days		5 years	5 years
Cash proceeds from exercise of warrants								$ 289	$ 0
Subsequent Event [Member]
Subsequent Events [Abstract]
Issuance of common stock, net (in shares)	3,597,880	5,130,228
Public offering price (in dollars per share)	$ 0.4725	$ 0.434
Gross proceeds from public stock offering	$ 1,700	$ 2,200
Warrants to purchase shares of common stock (in shares)	1,798,940	2,565,114
Exercise price of warrants (in dollars per share)	$ 0.41	$ 0.3715
Warrants exercisable period	30 days
Warrant expiry period	5 years 6 months	5 years 6 months
Cash proceeds from exercise of warrants							$ 1,000
Warrants exercised to purchase common stock (in shares)							3
PPP Loans [Member] | Subsequent Event [Member]
Subsequent Events [Abstract]
Face amount of debt										$ 1,660
Interest rate percentage										1.00%