TELA Bio (TELA) 10-Q 15 May 20 2020 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2020	May 05, 2020
Document and Entity Information
Document Type	10-Q
Document Period End Date	Mar. 31, 2020
Entity Registrant Name	TELA Bio, Inc.
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		11,407,625
Entity Central Index Key	0001561921
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
Amendment Flag	false

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 41,411	$ 45,302
Short-term investments	5,289	9,285
Accounts receivable, net	2,047	2,836
Inventory	4,803	4,603
Prepaid expenses and other assets	1,763	2,308
Total current assets	55,313	64,334
Property and equipment, net	693	677
Intangible assets, net	2,835	2,911
Total assets	58,841	67,922
Current liabilities:
Accounts payable	1,389	3,171
Accrued expenses	2,834	3,533
Other current liabilities	9	9
Total current liabilities	4,232	6,713
Long‑term debt with related party	30,381	30,243
Other long‑term liabilities	1	4
Total liabilities	34,614	36,960
Stockholders’ equity:
Preferred stock; $0.001 par value: 10,000,000 shares authorized; no shares issued and outstanding
Common stock; $0.001 par value: 200,000,000 shares authorized; 11,407,998 and 11,406,976 shares issued and 11,407,600 and 11,406,221 shares outstanding at March 31, 2020 and December 31, 2019, respectively	11	11
Additional paid-in capital	199,287	198,829
Accumulated other comprehensive income (loss)	8	(19)
Accumulated deficit	(175,079)	(167,859)
Total stockholders’ equity	24,227	30,962
Total liabilities and stockholders’ equity	$ 58,841	$ 67,922

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2020	Dec. 31, 2019
Consolidated Balance Sheets
Preferred stock, Par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	10,000,000	10,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, Par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	200,000,000	200,000,000
Common stock, shares issued (in shares)	11,407,998	11,406,976
Common stock, shares outstanding (in shares)	11,407,600	11,406,221

Consolidated Statements of Oper

Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Consolidated Statements of Operations and Comprehensive Loss
Revenue	$ 3,726	$ 3,306
Cost of revenue (excluding amortization of intangible assets)	1,450	1,432
Amortization of intangible assets	76	76
Gross profit	2,200	1,798
Operating expenses:
Sales and marketing	5,269	3,995
General and administrative	2,518	1,324
Research and development	912	1,659
Total operating expenses	8,699	6,978
Loss from operations	(6,499)	(5,180)
Other (expense) income:
Interest expense	(879)	(912)
Change in fair value of preferred stock warrant liability		36
Other income	158	90
Total other (expense) income	(721)	(786)
Net loss	(7,220)	(5,966)
Accretion of redeemable convertible preferred stock to redemption value		(2,025)
Net loss attributable to common stockholders	$ (7,220)	$ (7,991)
Net loss per common share, basic and diluted	$ (0.63)	$ (27)
Weighted average common shares outstanding, basic and diluted	11,406,783	295,992
Comprehensive loss:
Net loss	$ (7,220)	$ (5,966)
Foreign currency translation adjustment	27	(4)
Comprehensive loss	$ (7,193)	$ (5,970)

Consolidated Statements of Rede

Consolidated Statements of Redeemable Convertible Preferred Stock and Stockholders’ Equity (Deficit) - USD ($) $ in Thousands	Series A Redeemable convertible preferred stockPreferred Stock [Member]	Series B Redeemable convertible preferred stockPreferred Stock [Member]	Common stock	Additional paid-in capital	Accumulated other comprehensive loss	Accumulated deficit	Total
Balance at Beginning of period at Dec. 31, 2018	$ 33,112	$ 91,038
Balance at Beginning of period (in shares) at Dec. 31, 2018	22,501,174	63,032,500
Increase (Decrease) in Temporary Equity [Roll Forward]
Sale of Series B redeemable convertible preferred stock, net of stock issue costs of $19		431,034
Sale of Series B redeemable convertible preferred stock, net of stock issue costs of $19		$ 481
Accretion of redeemable convertible preferred stock to redemption value	$ 444	1,581
Balance at Ending period at Mar. 31, 2019	$ 33,556	$ 93,100
Balance at Ending period (in shares) at Mar. 31, 2019	22,501,174	63,463,534
Balance at Beginning of period at Dec. 31, 2018						$ (137,860)	$ (137,860)
Balance at Beginning of period (in shares) at Dec. 31, 2018			295,717
Increase (Decrease) in Temporary Equity [Roll Forward]
Vesting of common stock previously subject to repurchase (in shares)			130
Exercise of stock options (in shares)			398
Exercise of stock options				$ 3			3
Foreign currency translation adjustment					$ (4)		(4)
Stock-based compensation expense				60			60
Accretion of redeemable convertible preferred stock to redemption value				(63)		(1,962)	(2,025)
Net loss						(5,966)	(5,966)
Balance at Ending period at Mar. 31, 2019					(4)	(145,788)	(145,792)
Balance at Ending period (in shares) at Mar. 31, 2019			296,245
Balance at Beginning of period at Dec. 31, 2019			$ 11	198,829	(19)	(167,859)	30,962
Balance at Beginning of period (in shares) at Dec. 31, 2019			11,406,221
Increase (Decrease) in Temporary Equity [Roll Forward]
Vesting of common stock previously subject to repurchase (in shares)			90
Vesting of common stock previously subject to repurchase				1			$ 1
Exercise of stock options (in shares)			1,289				1,289
Exercise of stock options				8			$ 8
Foreign currency translation adjustment					27		27
Stock-based compensation expense				449			449
Net loss						(7,220)	(7,220)
Balance at Ending period at Mar. 31, 2020			$ 11	$ 199,287	$ 8	$ (175,079)	$ 24,227
Balance at Ending period (in shares) at Mar. 31, 2020			11,407,600

Consolidated Statements of Re_2

Consolidated Statements of Redeemable Convertible Preferred Stock and Stockholders’ Equity (Deficit) (Parenthetical) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Series B Redeemable convertible preferred stock
Stock issue costs	$ 19

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Cash flows from operating activities:
Net loss	$ (7,220)	$ (5,966)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation expense	56	70
Noncash interest expense	134	119
Amortization of intangible assets	76	76
Inventory excess and obsolescence charge	405	739
Change in fair value of warrants		(36)
Stock‑based compensation expense	449	60
Change in operating assets and liabilities:
Accounts receivable	781	(579)
Inventory	(617)	(802)
Prepaid expenses and other assets	544	41
Accounts payable	(1,261)	(945)
Accrued expenses and other liabilities	(692)	(554)
Foreign currency remeasurement loss	38
Net cash used in operating activities	(7,307)	(7,777)
Cash flows from investing activities:
Proceeds from the sale and maturity of short-term investments	4,000
Payment for intangible asset		(500)
Purchase of property and equipment	(68)	(48)
Net cash provided by (used in) investing activities	3,932	(548)
Cash flows from financing activities:
Payment of initial public offering costs	(522)
Proceeds from issuance of Series B redeemable convertible preferred stock, net of offering costs		481
Proceeds from exercise of stock options	8	3
Net cash (used in) provided by financing activities	(514)	484
Effect of exchange rate on cash	(2)	(5)
Net decrease in cash and cash equivalents	(3,891)	(7,846)
Cash and cash equivalents, beginning of period	45,302	17,278
Cash and cash equivalents, end of period	41,411	9,432
Supplemental disclosure of cash flow information:
Cash paid during the period for interest	745	793
Supplemental disclosures of noncash investing and financing activities:
Accretion of redeemable convertible preferred stock		2,025
Intangible assets in accrued expenses and other liabilities		$ 2,000
Property and equipment purchases in accounts payable	4
Issuance of common stock for early exercised stock options	$ 1

Background

Background	3 Months Ended
	Mar. 31, 2020
Background
Background	(1) Background TELA Bio, Inc. (the “Company”) was incorporated in the state of Delaware on April 17, 2012 and wholly owns TELA Bio Limited, a company incorporated in the United Kingdom. The Company is focused on the commercialization and sale of OviTex Reinforced Tissue Matrix, which utilizes surgical reconstruction medical device technology licensed from a strategic partner and on the research and development of additional medical devices with this strategic partner and on other internally developed technologies. In April 2019, the Company received 510(k) clearance from the U.S. Food and Drug Administration (“FDA”) for OviTex PRS Reinforced Tissue Matrix (“OviTex PRS”), which addresses unmet needs in plastic and reconstructive surgery. The Company’s principal corporate office and research facility is located in Malvern, Pennsylvania.

Risks and Liquidity

Risks and Liquidity	3 Months Ended
	Mar. 31, 2020
Risks and Liquidity
Risks and Liquidity	(2) Risks and Liquidity The Company’s operations to date have focused on commercializing products, developing and acquiring technology and assets, business planning, raising capital and organization and staffing. The Company has incurred recurring losses and negative cash flows from operations since inception and has an accumulated deficit of $175.1 million as of March 31, 2020. The Company anticipates incurring additional losses until such time, if ever, it can generate sufficient revenue from its products to cover its expenses and has limited resources available to fund current commercialization and research and development activities. In November 2019, the Company closed its IPO in which the Company issued and sold 4,398,700 shares of its common stock at a public offering price of $13.00 per share, including 398,700 shares of the Company’s common stock sold pursuant to the underwriters’ option to purchase additional shares. The Company received net proceeds of $50.6 million after deducting underwriting discounts, commissions and other offering expenses. The operations of the Company are subject to certain risks and uncertainties including, among others, uncertainty of product development, the impact of COVID-19, the ongoing economic uncertainty, technological uncertainty, commercial acceptance of any developed products, alternative competing technologies, dependence on collaborative partners, uncertainty regarding patents and proprietary rights, comprehensive government regulations, and dependence on key personnel.

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2020
Summary of Significant Accounting Policies
Summary of Significant Accounting Policies	(3) Summary of Significant Accounting Policies The Company’s complete summary of significant accounting policies can be found in “Note 3, Summary of Significant Accounting Policies” in the December 31, 2019 consolidated financial statements included in the Company’s Annual Report. Any reference in these notes to applicable guidance is meant to refer to generally accepted accounting principles (“GAAP”) in the United States as found in the Accounting Standards Codification (“ASC”) and Accounting Standards Updates (“ASU”) promulgated by the Financial Accounting Standards Board (“FASB”). Interim Financial Statements The accompanying unaudited interim consolidated financial statements have been prepared from the books and records of the Company in accordance with GAAP for interim financial information and Rule 10‑01 of Regulation S‑X promulgated by the SEC, which permits reduced disclosures for interim periods. All adjustments, consisting only of normal recurring adjustments, necessary for a fair presentation of the accompanying consolidated balance sheets and statements of operations and comprehensive loss, redeemable convertible preferred stock and stockholders’ equity (deficit) and cash flows have been made. Although these interim consolidated financial statements do not include all of the information and footnotes required for complete annual consolidated financial statements, management believes the disclosures are adequate to make the information presented not misleading. Unaudited interim results of operations and cash flows are not necessarily indicative of the results that may be expected for the full year. Unaudited interim consolidated financial statements and footnotes should be read in conjunction with the December 31, 2019 consolidated financial statements and footnotes included in the Annual Report. Use of Estimates The preparation of consolidated 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 contingent liabilities at the date of the consolidated financial statements and the reported amounts of revenue and expenses during the reporting period. The most significant judgments are employed in estimates used to determine the fair value of stock‑based awards issued and recoverability of the carrying value of the Company’s inventory. As future events and their effects cannot be determined with precision, actual results may differ significantly from these estimates. The full extent to which the COVID-19 pandemic will directly or indirectly impact the Company’s business, results of operations and financial condition, including revenue, expenses, manufacturing, research and development costs and employee-related compensation, will depend on future developments that are highly uncertain, including new information that may emerge concerning COVID-19 and the actions taken to contain or treat COVID-19, as well as the economic impact on local, regional, national and international customers and markets. Management has made estimates of the impact of COVID-19 within the Company’s consolidated financial statements and there may be changes to those estimates in future periods. Actual results may differ from these estimates. Short-Term Investments Short-term investments consist of investments in corporate debt securities with a maturity of greater than three months when acquired. The Company classifies these investments as available-for-sale securities. These investments are reported at fair value with the related unrealized gains and losses included in accumulated other comprehensive income (loss), a component of stockholders’ equity. Short-term investments consisted of the following (in thousands): Estimated Amortization/ Unrealized Fair Cost Accretion Gains/(Losses) Value March 31, 2020: Corporate debt securities $ 5,285 $ 4 $ — $ 5,289 December 31, 2019: Corporate debt securities $ 9,284 $ 5 $ (4) $ 9,285 Revenue Recognition Under ASC Topic 606, Revenue from Contracts with Customers , an entity recognizes revenue when its customer obtains control of the promised good, in an amount that reflects the consideration that the entity expects to be entitled in exchange for those goods. The Company performs the following five steps to recognize revenue under ASC Topic 606: (i) identify the contract(s) with a customer, (ii) identify the performance obligations in the contract, (iii) determine the transaction price, (iv) allocate the transaction price to the performance obligations in the contract, and (v) recognize revenue when (or as) the entity satisfies a performance obligation. The Company only recognizes revenue when it is probable that it will collect the consideration to which it is entitled in exchange for the goods or services that will be transferred to the customer. A significant portion of the Company’s revenue is generated from product shipped to a customer or from consigned inventory maintained at hospitals. Revenue from the sale of consigned products is recognized when control is transferred to the customer, which occurs at the time the product is used in a surgical procedure. For product that is not held on consignment, the Company recognizes revenue when control transfers to the customer which occurs at the time the product is shipped or delivered. For all of the Company’s contracts, the only identified performance obligation is providing the product to the customer. Payment terms with customers do not exceed one year and, therefore, the Company does not account for a financing component in its arrangements. There are no incremental costs of obtaining a contract that would rise to or enhance an asset other than product costs, which are a component of inventory. The Company expenses incremental costs of obtaining a contract with a customer (e.g., sales commissions) when incurred as the period of benefit is less than one year. Fees charged to customers for shipping are recognized as revenue. The following table presents revenue disaggregated for the three months ended March 31, 2020 (in thousands): OviTex $ 3,239 OviTex PRS 487 Total revenue $ 3,726 Sales of OviTex accounted for all of the Company’s revenue for the three months ended March 31, 2019. Sales outside of the U.S. are immaterial for both the three months ended March 31, 2020 and 2019. Fair value of financial instruments Fair value is the price that could be received to sell an asset or paid to transfer a liability in an orderly transaction among market participants. Fair value determination in accordance with applicable accounting guidance requires that a number of significant judgments are made. Additionally, fair value is used on a nonrecurring basis to evaluate assets for impairment or as required for disclosure purposes by applicable accounting guidance on disclosures about fair value of financial instruments. Depending on the nature of the assets and liabilities, various valuation techniques and assumptions are used when estimating fair value. The carrying amounts of certain of the Company’s financial instruments, including cash and cash equivalents, accounts receivable and other assets, and accounts payable are shown at cost, which approximates fair value due to the short‑term nature of these instruments. Due to the related‑party relationship of the credit facility (the “OrbiMed Credit Facility”) with OrbiMed Royalty Opportunities IP, LP (“OrbiMed”) (Note 5), it is impractical to determine the fair value of the debt. The Company follows the provisions of FASB ASC Topic 820, Fair Value Measurement , for financial assets and liabilities measured on a recurring basis. The guidance requires fair value measurements be classified and disclosed in one of the following three categories: · Level 1: Unadjusted quoted prices in active markets that are accessible at the measurement date for identical, unrestricted assets or liabilities. · Level 2: Quoted prices in markets that are not active, or inputs which are observable, either directly or indirectly, for substantially the full term of the asset or liabilities. · Level 3: Prices or valuation techniques that require inputs that are both significant to the fair value measurement and unobservable (i.e., supported by little or no market activity). The following fair value hierarchy table presents information about each major category of the Company’s financial assets and liabilities measured at fair value on a recurring basis (in thousands): Fair value measurement at reporting date using Quoted prices in active markets Significant other Significant for identical observable unobservable assets inputs inputs (Level 1) (Level 2) (Level 3) March 31, 2020: Assets: Cash equivalents – money market fund $ 38,979 $ — $ — Short-term investments – corporate debt securities $ — $ 5,289 $ — December 31, 2019: Assets: Cash equivalents – money market fund $ 34,918 $ — $ — Cash equivalents – corporate debt securities $ — $ 8,850 $ — Cash equivalents – government agency securities $ — $ 1,000 $ — Short-term investments – corporate debt securities $ — $ 9,285 $ — At March 31, 2019, preferred stock warrants were outstanding and were a level 3 measurement. A rollforward of the warrant liability is as follows (in thousands): January 1, 2019 $ 1,640 Change in fair value of warrants (36) March 31, 2019 $ 1,604 Net loss per share Basic and diluted net loss per common share is determined by dividing net loss attributable to common stockholders by the weighted‑average shares of common stock outstanding during the reporting period. The Company’s outstanding redeemable convertible preferred stock contractually entitled the holders of such shares to participate in distributions but contractually did not require the holders of such shares to participate in losses of the Company. Accordingly, in periods in which the Company reports a net loss attributable to common stockholders, diluted net loss per share attributable to common stockholders is the same as basic net loss per share attributable to common stockholders since dilutive shares are not assumed to have been issued if their effect is antidilutive. Therefore, the weighted‑average shares used to calculate both basic and diluted loss per share are the same. The following potentially dilutive securities have been excluded from the computation of diluted weighted‑average shares outstanding for the periods presented, as they would be antidilutive. Three months ended March 31, 2020 2019 Series A redeemable convertible preferred stock — 911,336 Series B redeemable convertible preferred stock — 2,570,376 Stock options (including shares subject to repurchase) 1,482,819 516,756 Series B redeemable convertible preferred stock warrants — 88,556 Common stock warrants 88,556 — Total 1,571,375 4,087,024 Amounts in the above table reflect the common stock equivalents of the noted instrument. Recently Issued Accounting Pronouncements In February 2016, the FASB issued ASU No. 2016-02, Leases , which requires a lessee to record a right-of-use asset and a corresponding lease liability on the balance sheet for all leases with terms longer than 12 months. A modified retrospective transition approach is required, applying the new standard to all leases existing at the date of initial application. An entity may choose to use either (1) its effective date or (2) the beginning of the earliest comparative period presented in the consolidated financial statements as its date of initial application. If an entity chooses the second option, the transition requirements for existing leases also apply to leases entered into between the date of initial application and the effective date. The standard is effective for the Company beginning January 1, 2021, with early adoption permitted. The Company plans to adopt this standard on January 1, 2021 and is currently evaluating the expected impact that the standard could have on its consolidated financial statements and related disclosures. In June 2018, the FASB issued ASU No. 2018-07, Compensation—Stock Compensation (Topic 718) Improvements to Nonemployee Share-Based Payment Accounting . The amendments in this update expand the scope of Topic 718 to include stock-based payment transactions for acquiring goods and services from nonemployees. Under this ASU, an entity should apply the requirements of Topic 718 to nonemployee awards except for specific guidance on inputs to an option pricing model and the attribution of costs (i.e., the period of time over which stock-based payment awards vest and the pattern of cost recognition over that period). The guidance is effective for the Company beginning January 1, 2020, with early adoption permitted. The adoption of this guidance did not have any impact on the consolidated financial statements and related disclosures. In August 2018, the FASB issued ASU No. 2018-13, Disclosure Framework—Changes to the Disclosure Requirements for Fair Value Measurements, which changes the fair value measurement disclosure requirements of ASC Topic 820. The goal of the ASU is to improve the effectiveness of ASC Topic 820's disclosure requirements. The standard is effective for the Company beginning January 1, 2020. The adoption of this guidance did not have any impact on the consolidated financial statements and related disclosures.

Accrued Expenses

Accrued Expenses	3 Months Ended
	Mar. 31, 2020
Accrued Expenses
Accrued Expenses	(4) Accrued Expenses Accrued expenses consisted of the following (in thousands): March 31, December 31, 2020 2019 Compensation and related benefits $ 1,051 $ 2,310 Interest 43 41 Third-party and professional fees 1,371 641 Research and development expenses 15 35 Other 354 506 $ 2,834 $ 3,533

Long term Debt

Long term Debt	3 Months Ended
	Mar. 31, 2020
Long term Debt
Long term Debt	(5) Long‑term Debt Long‑term debt consisted of the following (in thousands): March 31, December 31, 2020 2019 OrbiMed Term Loan (related party) $ 30,000 $ 30,000 End of term charge 3,000 3,000 Unamortized end of term charge and issuance costs (2,619) (2,757) Long-term debt with related party $ 30,381 $ 30,243 OrbiMed Term Loan (Related Party) Pursuant to the OrbiMed Credit Facility, which consists of up to $35.0 million in term loans (the “OrbiMed Term Loans”), the Company provided a first priority security interest in all existing and future acquired assets, excluding intellectual property and certain other assets, owned by the Company. The OrbiMed Term Loans consist of two tranches, a $30.0 million Tranche 1 (“Tranche 1”) and a $5.0 million Tranche 2 (“Tranche 2”). In November 2018, the Company borrowed $30.0 million of Tranche 1 and used a portion of the proceeds to repay the MidCap Credit Facility and will use the remaining proceeds to fund operations and capital expenditures. The Company elected not to borrow Tranche 2 prior to its expiration on December 31, 2019. The OrbiMed Credit Facility contains a negative pledge on intellectual property owned by the Company. The OrbiMed Credit Facility also contains customary indemnification obligations and customary events of default, including, among other things, (i) nonpayment, (ii) breach of warranty, (iii) nonperformance of covenants and obligations, (iv) default on other indebtedness, (v) judgments, (iv) change of control, (vii) bankruptcy and insolvency, (viii) impairment of security, (ix) key permit events, (x) key person event, (xi) regulatory matters, (xii) and key contracts. In addition, the Company must maintain a minimum cash balance of $2.0 million. In the event of default under the OrbiMed Credit Facility, the Company would be required to pay interest on principal and all other due and unpaid obligations at the current rate in effect plus 3%. The OrbiMed Term Loan matures on November 16, 2023 and bears interest at a rate equal to 7.75% plus the greater of one‑month LIBOR or 2.0%. At March 31, 2020, the interest rate was 9.75%. The Company is required to make 60 monthly interest payments beginning on November 30, 2018, with the entire principal payment due at maturity. The OrbiMed Term Loans have a prepayment penalty equal to 10.0% of the prepaid principal amount prior to the second anniversary of the Term Loans, 5.0% of the prepaid principal amount after the second anniversary but prior to the third anniversary and 2.5% of the prepaid principal amount after the third anniversary. The Company is also required to pay an exit fee at the time of maturity or prepayment event equal to 10.0% of all principal borrowings (the “End of Term Charge”) and an administration fee equal to $10,000 on the last day of each quarter until all obligations have been paid in full. In conjunction with the closing of the OrbiMed Term Loans, the Company incurred $0.3 million of third‑party and lender fees, which along with the End of Term charge of $3.0 million were recorded as debt issuance costs, and are being recognized as interest expense over the term of the loan using the effective‑interest method. Interest expense associated with the OrbiMed Credit Facility recorded for both the three months ended March 31, 2020 and 2019 was $0.9 million, $0.1 million was related to the amortization of debt issuance costs.

Stockholders_ Equity (Deficit)

Stockholders’ Equity (Deficit)	3 Months Ended
	Mar. 31, 2020
Stockholders’ Equity (Deficit)
Stockholders’ Equity (Deficit)	(6) Stockholders’ Equity (Deficit) Initial Public Offering In November 2019, the Company closed its IPO in which the Company issued and sold 4,398,700 shares of its common stock at a public offering price of $13.00 per share, including 398,700 shares of the Company’s common stock sold pursuant to the underwriters’ option to purchase additional shares. The Company received net proceeds of $50.6 million after deducting underwriting discounts, commissions and other offering expenses. In addition, immediately prior to the closing of the IPO, all of the Company’s outstanding shares of redeemable convertible preferred stock, including accrued dividends payable converted into an aggregate of 6,708,649 shares of common stock and the Company’s outstanding warrants to purchase shares of preferred stock were automatically converted into warrants to purchase an aggregate of 88,556 shares of common stock. Warrants The Company had the following warrants outstanding to purchase common stock at March 31, 2020: Exercise Expiration Outstanding price dates Common stock warrants issued to MidCap 8,379 $ 28.65 Common stock warrants issued to note payable holders 15,712 28.65 Common stock warrants issued to convertible promissory note holders 64,465 $ 28.65 88,556

Stock-Based Compensation

Stock-Based Compensation	3 Months Ended
	Mar. 31, 2020
Stock-Based Compensation
Stock-Based Compensation	(7) Stock‑Based Compensation The Company has two equity incentive plans: the 2012 Stock Incentive Plan and the 2019 Equity Incentive Plan. New awards can only be granted under the 2019 Equity Incentive Plan (the “Plan”). At March 31, 2020, 259,065 shares were available for future issuances. The Plan provides for the grant of incentive stock options, nonqualified stock options, restricted stock awards, restricted stock units and/or stock appreciation rights to employees, directors, and other persons, as determined by the Company’s board of directors. The Company’s stock options vest based on the terms in each award agreement and generally vest over four years and have a term of 10 years. The Company estimates forfeitures that it expects will occur and adjusts expense for actual forfeitures in the periods they occur. The Company measures employee and nonemployee stock‑based awards at grant‑date fair value and records compensation expense on a straight‑line basis over the vesting period of the award. The Company recorded stock‑based compensation expense in the following expense categories of its accompanying consolidated statements of operations and comprehensive loss (in thousands): Three months ended March 31, 2020 2019 Sales and marketing $ 161 $ 15 General and administrative 209 34 Research and development 79 11 Total stock‑based compensation $ 449 $ 60 The following table summarizes stock option activity for the Plan: Weighted average Weighted remaining Number of average exercise contractual term shares price per share (years) Outstanding at January 1, 2020 1,420,942 $ 10.35 Granted 71,940 15.87 Exercised (1,289) 5.93 Canceled/forfeited (9,172) 11.55 Outstanding at March 31, 2020 1,482,421 10.61 8.57 Vested and expected to vest at March 31, 2020 1,385,789 $ 10.50 8.51 Exercisable at March 31, 2020 400,170 $ 5.94 6.13 The 2012 Stock Incentive Plan and the 2019 Equity Incentive Plan provide the holders of stock options an election to early exercise prior to vesting. The Company has the right, but not the obligation, to repurchase early exercised options without transferring any appreciation to the employee if the employee terminates employment before the end of the original vesting period. The repurchase price is the lesser of the original exercise price or the then fair value of the common stock. At March 31, 2020, $2,000 of proceeds from early exercised options are recognized as a current liability in other current liabilities in the accompanying consolidated balance sheet. The following table summarizes activity relating to early exercise of stock options: Number of shares Unvested balance at January 1, 2020 755 Vested (90) Forfeited (267) Unvested balance at March 31, 2020 398 The weighted average grant‑date fair value per share of options granted was $8.48 during the three months ended March 31, 2020. The aggregate intrinsic value of options exercised was $12,000 for the three months ended March 31, 2020. At March 31, 2020, the total unrecognized compensation expense related to unvested employee and nonemployee stock option awards was $5.8 million, which is expected to be recognized in expense over a weighted‑average period of approximately 3.25 years. Estimating Fair Value of Stock Options The fair value of each grant of stock options was determined by the Company using the methods and assumptions discussed below. Certain of these inputs are subjective and generally requires judgment to determine. Expected term – The expected term of stock options represents the weighted average period the stock options are expected to be outstanding. The Company uses the simplified method for estimating the expected term as provided by the Securities and Exchange Commission. The simplified method calculates the expected term as the average time to vesting and the contractual life of the options. Expected volatility – Due to the Company’s limited operating history and lack of company‑specific historical or implied volatility, the expected volatility assumption was determined by examining the historical volatilities of a group of industry peers whose share prices are publicly available. Risk‑free interest rate – The risk‑free rate assumption is based on the U.S. Treasury instruments, the terms of which were consistent with the expected term of the Company’s stock options. Expected dividend – The Company has not paid and does not intend to pay dividends. The fair value of each option was estimated on the date of grant using the weighted average assumptions in the table below: Three months ended March 31, 2020 Expected dividend yield — Expected volatility 55.5 % Risk‑free interest rate 1.44 % Expected term 6.25 Years

Related-Party Transactions

Related-Party Transactions	3 Months Ended
	Mar. 31, 2020
Related-Party Transactions
Related-Party Transactions	(8) Related‑Party Transactions On November 16, 2018, the Company entered into a senior secured term loan facility with OrbiMed, an entity affiliated with an owner of a material amount of the Company’s outstanding voting securities. The terms of the debt and related components are further described in more detail in Note 5.

Subsequent Events

Subsequent Events	3 Months Ended
	Mar. 31, 2020
Subsequent Events
Subsequent Events	(9) Subsequent Event In light of the impacts of the COVID-19 pandemic on the Company’s business, on April 28, 2020, the Board of Directors of the Company, at the request of management of the Company, approved a temporary reduction of the base salaries for all employees, including its senior executive officers and vice presidents (the “Salary Reduction”). The base salaries of each of the Company’s senior executives have been reduced by 30% and the base salaries of each of the Company’s vice presidents have been reduced by 25%. In addition, certain senior executives volunteered to reduce their salaries by an additional 5%, for a total reduction of 35% for those individuals. Reductions for other employees varied from 5% to 20%. The Salary Reduction commenced on April 30, 2020 and will continue through July 15, 2020. In addition, the Company has suspended its matching contributions to all participants under the Company’s 401(k) Retirement Plan.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2020
Summary of Significant Accounting Policies
Interim Financial Statements	Interim Financial Statements The accompanying unaudited interim consolidated financial statements have been prepared from the books and records of the Company in accordance with GAAP for interim financial information and Rule 10‑01 of Regulation S‑X promulgated by the SEC, which permits reduced disclosures for interim periods. All adjustments, consisting only of normal recurring adjustments, necessary for a fair presentation of the accompanying consolidated balance sheets and statements of operations and comprehensive loss, redeemable convertible preferred stock and stockholders’ equity (deficit) and cash flows have been made. Although these interim consolidated financial statements do not include all of the information and footnotes required for complete annual consolidated financial statements, management believes the disclosures are adequate to make the information presented not misleading. Unaudited interim results of operations and cash flows are not necessarily indicative of the results that may be expected for the full year. Unaudited interim consolidated financial statements and footnotes should be read in conjunction with the December 31, 2019 consolidated financial statements and footnotes included in the Annual Report.
Use of Estimates	Use of Estimates The preparation of consolidated 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 contingent liabilities at the date of the consolidated financial statements and the reported amounts of revenue and expenses during the reporting period. The most significant judgments are employed in estimates used to determine the fair value of stock‑based awards issued and recoverability of the carrying value of the Company’s inventory. As future events and their effects cannot be determined with precision, actual results may differ significantly from these estimates. The full extent to which the COVID-19 pandemic will directly or indirectly impact the Company’s business, results of operations and financial condition, including revenue, expenses, manufacturing, research and development costs and employee-related compensation, will depend on future developments that are highly uncertain, including new information that may emerge concerning COVID-19 and the actions taken to contain or treat COVID-19, as well as the economic impact on local, regional, national and international customers and markets. Management has made estimates of the impact of COVID-19 within the Company’s consolidated financial statements and there may be changes to those estimates in future periods. Actual results may differ from these estimates.
Short-Term Investments	Short-Term Investments Short-term investments consist of investments in corporate debt securities with a maturity of greater than three months when acquired. The Company classifies these investments as available-for-sale securities. These investments are reported at fair value with the related unrealized gains and losses included in accumulated other comprehensive income (loss), a component of stockholders’ equity. Short-term investments consisted of the following (in thousands): Estimated Amortization/ Unrealized Fair Cost Accretion Gains/(Losses) Value March 31, 2020: Corporate debt securities $ 5,285 $ 4 $ — $ 5,289 December 31, 2019: Corporate debt securities $ 9,284 $ 5 $ (4) $ 9,285
Revenue Recognition	Revenue Recognition Under ASC Topic 606, Revenue from Contracts with Customers , an entity recognizes revenue when its customer obtains control of the promised good, in an amount that reflects the consideration that the entity expects to be entitled in exchange for those goods. The Company performs the following five steps to recognize revenue under ASC Topic 606: (i) identify the contract(s) with a customer, (ii) identify the performance obligations in the contract, (iii) determine the transaction price, (iv) allocate the transaction price to the performance obligations in the contract, and (v) recognize revenue when (or as) the entity satisfies a performance obligation. The Company only recognizes revenue when it is probable that it will collect the consideration to which it is entitled in exchange for the goods or services that will be transferred to the customer. A significant portion of the Company’s revenue is generated from product shipped to a customer or from consigned inventory maintained at hospitals. Revenue from the sale of consigned products is recognized when control is transferred to the customer, which occurs at the time the product is used in a surgical procedure. For product that is not held on consignment, the Company recognizes revenue when control transfers to the customer which occurs at the time the product is shipped or delivered. For all of the Company’s contracts, the only identified performance obligation is providing the product to the customer. Payment terms with customers do not exceed one year and, therefore, the Company does not account for a financing component in its arrangements. There are no incremental costs of obtaining a contract that would rise to or enhance an asset other than product costs, which are a component of inventory. The Company expenses incremental costs of obtaining a contract with a customer (e.g., sales commissions) when incurred as the period of benefit is less than one year. Fees charged to customers for shipping are recognized as revenue. The following table presents revenue disaggregated for the three months ended March 31, 2020 (in thousands): OviTex $ 3,239 OviTex PRS 487 Total revenue $ 3,726 Sales of OviTex accounted for all of the Company’s revenue for the three months ended March 31, 2019. Sales outside of the U.S. are immaterial for both the three months ended March 31, 2020 and 2019.
Fair value of financial instruments	Fair value of financial instruments Fair value is the price that could be received to sell an asset or paid to transfer a liability in an orderly transaction among market participants. Fair value determination in accordance with applicable accounting guidance requires that a number of significant judgments are made. Additionally, fair value is used on a nonrecurring basis to evaluate assets for impairment or as required for disclosure purposes by applicable accounting guidance on disclosures about fair value of financial instruments. Depending on the nature of the assets and liabilities, various valuation techniques and assumptions are used when estimating fair value. The carrying amounts of certain of the Company’s financial instruments, including cash and cash equivalents, accounts receivable and other assets, and accounts payable are shown at cost, which approximates fair value due to the short‑term nature of these instruments. Due to the related‑party relationship of the credit facility (the “OrbiMed Credit Facility”) with OrbiMed Royalty Opportunities IP, LP (“OrbiMed”) (Note 5), it is impractical to determine the fair value of the debt. The Company follows the provisions of FASB ASC Topic 820, Fair Value Measurement , for financial assets and liabilities measured on a recurring basis. The guidance requires fair value measurements be classified and disclosed in one of the following three categories: · Level 1: Unadjusted quoted prices in active markets that are accessible at the measurement date for identical, unrestricted assets or liabilities. · Level 2: Quoted prices in markets that are not active, or inputs which are observable, either directly or indirectly, for substantially the full term of the asset or liabilities. · Level 3: Prices or valuation techniques that require inputs that are both significant to the fair value measurement and unobservable (i.e., supported by little or no market activity). The following fair value hierarchy table presents information about each major category of the Company’s financial assets and liabilities measured at fair value on a recurring basis (in thousands): Fair value measurement at reporting date using Quoted prices in active markets Significant other Significant for identical observable unobservable assets inputs inputs (Level 1) (Level 2) (Level 3) March 31, 2020: Assets: Cash equivalents – money market fund $ 38,979 $ — $ — Short-term investments – corporate debt securities $ — $ 5,289 $ — December 31, 2019: Assets: Cash equivalents – money market fund $ 34,918 $ — $ — Cash equivalents – corporate debt securities $ — $ 8,850 $ — Cash equivalents – government agency securities $ — $ 1,000 $ — Short-term investments – corporate debt securities $ — $ 9,285 $ — At March 31, 2019, preferred stock warrants were outstanding and were a level 3 measurement. A rollforward of the warrant liability is as follows (in thousands): January 1, 2019 $ 1,640 Change in fair value of warrants (36) March 31, 2019 $ 1,604
Net loss per share	Net loss per share Basic and diluted net loss per common share is determined by dividing net loss attributable to common stockholders by the weighted‑average shares of common stock outstanding during the reporting period. The Company’s outstanding redeemable convertible preferred stock contractually entitled the holders of such shares to participate in distributions but contractually did not require the holders of such shares to participate in losses of the Company. Accordingly, in periods in which the Company reports a net loss attributable to common stockholders, diluted net loss per share attributable to common stockholders is the same as basic net loss per share attributable to common stockholders since dilutive shares are not assumed to have been issued if their effect is antidilutive. Therefore, the weighted‑average shares used to calculate both basic and diluted loss per share are the same. The following potentially dilutive securities have been excluded from the computation of diluted weighted‑average shares outstanding for the periods presented, as they would be antidilutive. Three months ended March 31, 2020 2019 Series A redeemable convertible preferred stock — 911,336 Series B redeemable convertible preferred stock — 2,570,376 Stock options (including shares subject to repurchase) 1,482,819 516,756 Series B redeemable convertible preferred stock warrants — 88,556 Common stock warrants 88,556 — Total 1,571,375 4,087,024 Amounts in the above table reflect the common stock equivalents of the noted instrument.
Recently Issued Accounting Pronouncement	Recently Issued Accounting Pronouncements In February 2016, the FASB issued ASU No. 2016-02, Leases , which requires a lessee to record a right-of-use asset and a corresponding lease liability on the balance sheet for all leases with terms longer than 12 months. A modified retrospective transition approach is required, applying the new standard to all leases existing at the date of initial application. An entity may choose to use either (1) its effective date or (2) the beginning of the earliest comparative period presented in the consolidated financial statements as its date of initial application. If an entity chooses the second option, the transition requirements for existing leases also apply to leases entered into between the date of initial application and the effective date. The standard is effective for the Company beginning January 1, 2021, with early adoption permitted. The Company plans to adopt this standard on January 1, 2021 and is currently evaluating the expected impact that the standard could have on its consolidated financial statements and related disclosures. In June 2018, the FASB issued ASU No. 2018-07, Compensation—Stock Compensation (Topic 718) Improvements to Nonemployee Share-Based Payment Accounting . The amendments in this update expand the scope of Topic 718 to include stock-based payment transactions for acquiring goods and services from nonemployees. Under this ASU, an entity should apply the requirements of Topic 718 to nonemployee awards except for specific guidance on inputs to an option pricing model and the attribution of costs (i.e., the period of time over which stock-based payment awards vest and the pattern of cost recognition over that period). The guidance is effective for the Company beginning January 1, 2020, with early adoption permitted. The adoption of this guidance did not have any impact on the consolidated financial statements and related disclosures. In August 2018, the FASB issued ASU No. 2018-13, Disclosure Framework—Changes to the Disclosure Requirements for Fair Value Measurements, which changes the fair value measurement disclosure requirements of ASC Topic 820. The goal of the ASU is to improve the effectiveness of ASC Topic 820's disclosure requirements. The standard is effective for the Company beginning January 1, 2020. The adoption of this guidance did not have any impact on the consolidated financial statements and related disclosures

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2020
Summary of Significant Accounting Policies
Schedule Of Cash And Cash Equivalents And Short Term Investments	Short-term investments consisted of the following (in thousands): Estimated Amortization/ Unrealized Fair Cost Accretion Gains/(Losses) Value March 31, 2020: Corporate debt securities $ 5,285 $ 4 $ — $ 5,289 December 31, 2019: Corporate debt securities $ 9,284 $ 5 $ (4) $ 9,285
Disaggregation of Revenue	OviTex $ 3,239 OviTex PRS 487 Total revenue $ 3,726
Schedule of fair value of assets and liabilities measured on recurring basis	The following fair value hierarchy table presents information about each major category of the Company’s financial assets and liabilities measured at fair value on a recurring basis (in thousands): Fair value measurement at reporting date using Quoted prices in active markets Significant other Significant for identical observable unobservable assets inputs inputs (Level 1) (Level 2) (Level 3) March 31, 2020: Assets: Cash equivalents – money market fund $ 38,979 $ — $ — Short-term investments – corporate debt securities $ — $ 5,289 $ — December 31, 2019: Assets: Cash equivalents – money market fund $ 34,918 $ — $ — Cash equivalents – corporate debt securities $ — $ 8,850 $ — Cash equivalents – government agency securities $ — $ 1,000 $ — Short-term investments – corporate debt securities $ — $ 9,285 $ —
Schedule of warrant liability	January 1, 2019 $ 1,640 Change in fair value of warrants (36) March 31, 2019 $ 1,604
Schedule of dilutive securities excluded	Three months ended March 31, 2020 2019 Series A redeemable convertible preferred stock — 911,336 Series B redeemable convertible preferred stock — 2,570,376 Stock options (including shares subject to repurchase) 1,482,819 516,756 Series B redeemable convertible preferred stock warrants — 88,556 Common stock warrants 88,556 — Total 1,571,375 4,087,024

Accrued Expenses (Tables)

Accrued Expenses (Tables)	3 Months Ended
	Mar. 31, 2020
Accrued Expenses
Accrued Expenses	Accrued expenses consisted of the following (in thousands): March 31, December 31, 2020 2019 Compensation and related benefits $ 1,051 $ 2,310 Interest 43 41 Third-party and professional fees 1,371 641 Research and development expenses 15 35 Other 354 506 $ 2,834 $ 3,533

Long term Debt (Tables)

Long term Debt (Tables)	3 Months Ended
	Mar. 31, 2020
Long term Debt
Schedule of long term debt	Long‑term debt consisted of the following (in thousands): March 31, December 31, 2020 2019 OrbiMed Term Loan (related party) $ 30,000 $ 30,000 End of term charge 3,000 3,000 Unamortized end of term charge and issuance costs (2,619) (2,757) Long-term debt with related party $ 30,381 $ 30,243

Stockholders_ Equity (Deficit)

Stockholders’ Equity (Deficit) (Tables)	3 Months Ended
	Mar. 31, 2020
Stockholders’ Equity (Deficit)
Schedule of warrants outstanding to purchase common stock	Exercise Expiration Outstanding price dates Common stock warrants issued to MidCap 8,379 $ 28.65 Common stock warrants issued to note payable holders 15,712 28.65 Common stock warrants issued to convertible promissory note holders 64,465 $ 28.65 88,556

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2020
Stock-Based Compensation
Schedule of stock based compensation expense categories in statement of operations	The Company recorded stock‑based compensation expense in the following expense categories of its accompanying consolidated statements of operations and comprehensive loss (in thousands): Three months ended March 31, 2020 2019 Sales and marketing $ 161 $ 15 General and administrative 209 34 Research and development 79 11 Total stock‑based compensation $ 449 $ 60
Schedule of stock option activity	Weighted average Weighted remaining Number of average exercise contractual term shares price per share (years) Outstanding at January 1, 2020 1,420,942 $ 10.35 Granted 71,940 15.87 Exercised (1,289) 5.93 Canceled/forfeited (9,172) 11.55 Outstanding at March 31, 2020 1,482,421 10.61 8.57 Vested and expected to vest at March 31, 2020 1,385,789 $ 10.50 8.51 Exercisable at March 31, 2020 400,170 $ 5.94 6.13
Schedule of activity relating to early exercise of stock options	Number of shares Unvested balance at January 1, 2020 755 Vested (90) Forfeited (267) Unvested balance at March 31, 2020 398
Schedule of weighted average assumptions	Three months ended March 31, 2020 Expected dividend yield — Expected volatility 55.5 % Risk‑free interest rate 1.44 % Expected term 6.25 Years

Risks and Liquidity (Details)

Risks and Liquidity (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended
	Nov. 30, 2019	Mar. 31, 2020	Dec. 31, 2019
Unusual Risk or Uncertainty [Line Items]
Accumulated deficit		$ (175,079)	$ (167,859)
Received net proceeds of after deducting underwriting discounts, commissions and other offering expenses	$ 50,600
IPO
Unusual Risk or Uncertainty [Line Items]
Number of shares issued and sold	4,398,700
Public offering price per share	$ 13
Over-Allotment Option
Unusual Risk or Uncertainty [Line Items]
Number of shares issued and sold	398,700

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Short-Term Investments (Details) - Corporate debt securities - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Cash and Cash Equivalents [Line Items]
Cost	$ 5,285	$ 9,284
Amortization/ Accretion	4	5
Unrealized Gains/(Losses)		(4)
Estimated Fair Value	$ 5,289	$ 9,285

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Revenue Recognition (Details) $ in Millions	3 Months Ended
	Mar. 31, 2020USD ($)
Summary of Significant Accounting Policies
Incremental costs of obtaining a contract	$ 0

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Revenue Disaggregated (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Disaggregation of Revenue [Line Items]
Revenue	$ 3,726	$ 3,306
OviTex [Member]
Disaggregation of Revenue [Line Items]
Revenue	3,239
OviTex PRS [Member]
Disaggregation of Revenue [Line Items]
Revenue	$ 487

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Fair value of financial instruments (Details) - Recurring - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Level 1 | Money market funds
Fair value of financial instruments
Cash equivalents	$ 38,979	$ 34,918
Level 2 | Corporate debt securities
Fair value of financial instruments
Cash equivalents		8,850
Short-term investment – corporate debt securities	$ 5,289	9,285
Level 2 | Agency securities
Fair value of financial instruments
Cash equivalents		$ 1,000

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Warrant liability (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Summary of Significant Accounting Policies
Beginning balance	$ 1,640
Change in fair value of warrants	(36)
Ending balance	$ 1,604

Summary of Significant Accoun_9

Summary of Significant Accounting Policies - Potentially dilutive securities (Details) - shares	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Potentially dilutive securities
Potentially dilutive securities excluded from computation of diluted weighted average shares	1,571,375	4,087,024
Stock Options
Potentially dilutive securities
Potentially dilutive securities excluded from computation of diluted weighted average shares	1,482,819	516,756
Series A
Potentially dilutive securities
Potentially dilutive securities excluded from computation of diluted weighted average shares		911,336
Series B
Potentially dilutive securities
Potentially dilutive securities excluded from computation of diluted weighted average shares		2,570,376
Series B Redeemable Convertible Preferred Stock Warrants | Warrants
Potentially dilutive securities
Potentially dilutive securities excluded from computation of diluted weighted average shares		88,556
Common Stock Warrants
Potentially dilutive securities
Potentially dilutive securities excluded from computation of diluted weighted average shares	88,556

Accrued Expenses (Details)

Accrued Expenses (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Accrued Expenses
Compensation and related benefits	$ 1,051	$ 2,310
Interest	43	41
Professional fees	1,371	641
Research and development expenses	15	35
Other	354	506
Accrued Expenses, Total	$ 2,834	$ 3,533

Long term Debt - Schedule of lo

Long term Debt - Schedule of long term debt (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Debt
Long-term Debt	$ 30,381	$ 30,243
OrbiMed Term Loans (related party)
Debt
Long Term Debt	30,000	30,000
End of term charge	3,000	3,000
Unamortized issuance costs	(2,619)	(2,757)
Long-term Debt	$ 30,381	$ 30,243

Long term Debt - OrbiMed Term L

Long term Debt - OrbiMed Term Loan (related party) (Details)	3 Months Ended
	Mar. 31, 2020USD ($)tranche	Mar. 31, 2019USD ($)	Nov. 30, 2018USD ($)
OrbiMed Term Loans (related party)
Debt
Number of Tranches | tranche	2
Minimum Cash Balance	$ 2,000,000
Interest due to unpaid obligation	3.00%
Interest Rate (as a percent)	9.75%		7.75%
Number of Installment	60 months
Exit fee (as a percent)	10.00%
Administration Fees	$ 10,000
Debt issuance costs	300,000
Interest Expenses	900,000	$ 900,000
End of term charge	3,000,000
Amortization of debt issuance costs	$ 100,000	$ 100,000
OrbiMed Term Loans (related party) | Prior to second anniversary
Debt
Percentage of prepayment penalty on prepaid principal amount	10.00%
OrbiMed Term Loans (related party) | After second anniversary but prior to third anniversary
Debt
Percentage of prepayment penalty on prepaid principal amount	5.00%
OrbiMed Term Loans (related party) | After third anniversary
Debt
Percentage of prepayment penalty on prepaid principal amount	2.50%
OrbiMed Term Loans (related party) | LIBOR
Debt
Variable Interest Rate (as a percent)	2.00%
OrbiMed Term Loans (related party) | Maximum
Debt
Debt Amount	$ 35,000,000
Tranche One
Debt
Debt Amount	30,000,000		$ 30,000,000
Tranche Two
Debt
Debt Amount	$ 5,000,000

Stockholders_ Equity (Deficit_2

Stockholders’ Equity (Deficit) - IPO (Details) $ / shares in Units, $ in Millions	1 Months Ended
	Nov. 30, 2019USD ($)$ / sharesshares
Redeemable Convertible Preferred Stock and Stockholders’ Deficit
Received net proceeds of after deducting underwriting discounts, commissions and other offering expenses | $	$ 50.6
IPO
Redeemable Convertible Preferred Stock and Stockholders’ Deficit
Number of shares issued and sold	4,398,700
Public offering price per share | $ / shares	$ 13
Over-Allotment Option
Redeemable Convertible Preferred Stock and Stockholders’ Deficit
Number of shares issued and sold	398,700
Convertible Preferred Stock | IPO
Redeemable Convertible Preferred Stock and Stockholders’ Deficit
Aggregate of common stock	6,708,649
Warrants | IPO
Redeemable Convertible Preferred Stock and Stockholders’ Deficit
Aggregate of common stock	88,556

Stockholders_ Equity (Deficit_3

Stockholders’ Equity (Deficit) - Warrants outstanding (Details)	Mar. 31, 2020$ / sharesshares
Redeemable Convertible Preferred Stock and Stockholders’ Deficit
Warrants outstanding	88,556
MidCap Credit Facility | Warrants
Redeemable Convertible Preferred Stock and Stockholders’ Deficit
Warrants outstanding	8,379
warrants exercise price | $ / shares	$ 28.65
Notes payable | Warrants
Redeemable Convertible Preferred Stock and Stockholders’ Deficit
Warrants outstanding	15,712
warrants exercise price | $ / shares	$ 28.65
Convertible promissory notes | Warrants
Redeemable Convertible Preferred Stock and Stockholders’ Deficit
Warrants outstanding	64,465
warrants exercise price | $ / shares	$ 28.65

Stock-Based Compensation - Expe

Stock-Based Compensation - Expenses (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Stock-Based Compensation
Total stock-based compensation	$ 449	$ 60
Sales and marketing
Stock-Based Compensation
Total stock-based compensation	161	15
General and administrative
Stock-Based Compensation
Total stock-based compensation	209	34
Research and development
Stock-Based Compensation
Total stock-based compensation	$ 79	$ 11

Stock-Based Compensation - Stoc

Stock-Based Compensation - Stock Option Activity (Details)	3 Months Ended
	Mar. 31, 2020$ / sharesshares
Number of shares
Balance at beginning of period | shares	1,420,942
Granted | shares	71,940
Exercised | shares	(1,289)
Canceled/forfeited | shares	(9,172)
Balance at end of period | shares	1,482,421
Vested and expected to vest at end of period | shares	1,385,789
Exercisable at end of period | shares	400,170
Weighted average exercise price per share
Balance at beginning of period (in dollars per share) | $ / shares	$ 10.35
Granted ( in dollars per share) | $ / shares	15.87
Exercised (in dollars per share) | $ / shares	5.93
Canceled/forfeited (in dollars per share) | $ / shares	11.55
Balance at end of period (in dollars per share) | $ / shares	10.61
Vested and expected to vest at end of period (in dollars per share) | $ / shares	10.50
Exercisable at end of period (in dollars per share) | $ / shares	$ 5.94
Weighted average remaining contractual term
Weighted average remaining contractual term, outstanding	8 years 6 months 26 days
Weighted average remaining contractual term, Vested and expected to vest	8 years 6 months 4 days
Weighted average remaining contractual term, Exercisable	6 years 1 month 17 days

Stock-Based Compensation - Earl

Stock-Based Compensation - Early Exercise Of Stock Options (Details)	3 Months Ended
	Mar. 31, 2020shares
Stock-Based Compensation
Unvested balance at beginning of period	755
Vested	(90)
Forteited	(267)
Unvested balance at end of period	398

Stock-Based Compensation - Weig

Stock-Based Compensation - Weighted average assumptions (Details)	3 Months Ended
	Mar. 31, 2020
Stock-Based Compensation
Expected volatility	55.50%
Risk-free interest rate	1.44%
Expected term	6 years 3 months

Stock-Based Compensation - Narr

Stock-Based Compensation - Narratives (Details)	3 Months Ended
	Mar. 31, 2020USD ($)$ / sharesshares
Stock-Based Compensation
Weighted Average Grant Date Fair Value per share | $ / shares	$ 8.48
Aggregate intrinsic value	$ 12,000
2012 Stock Incentive Plan
Stock-Based Compensation
Shares available for future issuance | shares	259,065
Vesting Period	4 years
Vesting Term	P10Y
Unrecognized compensation expense	$ 5,800,000
Weighted Average period for recognition of unrecognized expenses	3 years 3 months
2012 Stock Incentive Plan | Current Liability
Stock-Based Compensation
Proceeds from early exercise of option	$ 2,000

Subsequent Events (Details)

Subsequent Events (Details) - Subsequent Event	Apr. 28, 2020
Executive Officer [Member]
Subsequent Events
Salary Reduction	30.00%
Volunteered Reduction Of Salary	5.00%
Salary Reduction, Including Volunteered Reduction	35.00%
Vice President [Member]
Subsequent Events
Salary Reduction	25.00%
Maximum | Other Employees [Member]
Subsequent Events
Salary Reduction	20.00%
Minimum | Other Employees [Member]
Subsequent Events
Salary Reduction	5.00%