Biora Therapeutics (BIOR) 10-Q 14 Nov 24 2024 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2024	Nov. 06, 2024
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2024
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q3
Entity Registrant Name	Biora Therapeutics, Inc.
Entity Central Index Key	0001580063
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Current Fiscal Year End Date	--12-31
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		4,522,702
Entity File Number	001-39334
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	27-3950390
Entity Address, Address Line One	4330 La Jolla Village Drive
Entity Address, Address Line Two	Suite 300
Entity Address, City or Town	San Diego
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	92122
City Area Code	833
Local Phone Number	727-2841
Document Quarterly Report	true
Document Transition Report	false
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	BIOR
Security Exchange Name	NASDAQ

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2024		Dec. 31, 2023
Current assets:
Cash, cash equivalents and restricted cash	$ 3,196		$ 15,211
Income tax receivable	868		830
Prepaid expenses and other current assets	1,990		3,030
Total current assets	6,054		19,071
Property and equipment, net	1,175		1,156
Right-of-use assets	1,011		1,614
Other assets	193		3,302
Goodwill	6,072		6,072
Total assets	14,505		31,215
Current liabilities:
Accounts payable	6,916		2,843
Accrued expenses and other current liabilities	21,404		17,319
Warrant liabilities	18,688		40,834
Convertible notes, net of unamortized discount of $73 as of September 30, 2024	4,527		0
Senior secured convertible notes, net of unamortized discount of $30,855 as of September 30, 2024 (Note 6)	14,344	[1]	0
Related party senior secured convertible notes, net of unamortized discount of $12,581 and $0 as of September 30, 2024 and December 31, 2023, respectively (including future interest of $14,242 and $1,976 as of September 30, 2024 and December 31, 2023, respectively) (Note 6)	19,721		1,976
Derivative liabilities	35,018		0
Total current liabilities	120,618		62,972
Convertible notes, net of unamortized discount of $259 as of December 31, 2023	0		9,966
Senior secured convertible notes, net of unamortized discount of $11,066 as of December 31, 2023 (Note 6)	0		14,591
Related party senior secured convertible notes, net of unamortized discount of $7,951 as of December 31, 2023 (including future interest of $9,747) (Note 6)	0		19,179
Derivative liabilities	0		22,899
Other long-term liabilities	516		3,029
Total liabilities	121,134		132,636
Commitments and contingencies (Note 8)
Stockholders' deficit:
Common stock - $0.001 par value; 300,000,000 and 164,000,000 shares authorized as of September 30, 2024 and December 31, 2023, respectively; 3,778,030 and 2,857,484 shares issued as of September 30, 2024 and December 31, 2023, respectively; 3,677,726 and 2,783,748 shares outstanding as of September 30, 2024 and December 31, 2023, respectively	3		2
Additional paid-in capital	879,530		868,613
Accumulated deficit	(967,084)		(950,958)
Treasury stock - at cost; 100,304 and 73,736 shares as of September 30, 2024 and December 31, 2023, respectively	(19,078)		(19,078)
Total stockholders' deficit	(106,629)		(101,421)
Total liabilities and stockholders' deficit	$ 14,505		$ 31,215
[1] (2) The face value includes $ 24.0 million in Payment Priority Notes (as defined below) and $ 1.8 million in PIK Notes (as defined below).

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	300,000,000	164,000,000
Common stock, shares issued	3,778,030	2,857,484
Common stock, shares outstanding	3,677,726	2,783,748
Treasury stock, at cost shares	100,304	73,736
Convertible Notes
Unamortized discount	$ 73
Senior Secured Convertible Notes
Unamortized discount	30,855
Related Party Senior Secured Convertible Notes
Unamortized discount	12,581	$ 0
Future interest	$ 14,242	1,976
Convertible Notes, Non current
Unamortized discount		259
Senior Secured Convertible Notes, Non Current
Unamortized discount		11,066
Related Party Senior Secured Convertible Notes, Non Current
Unamortized discount		7,951
Future interest		$ 9,747

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Statement [Abstract]
Revenues	$ 32	$ 0	$ 892	$ 4
Operating expenses:
Research and development	5,610	10,547	20,319	23,720
Selling, general and administrative	10,649	12,774	28,102	30,083
Total operating expenses	16,259	23,321	48,421	53,803
Loss from operations	(16,227)	(23,321)	(47,529)	(53,799)
Interest expense, net	(2,016)	(2,592)	(5,484)	(7,975)
Gain on warrant liabilities	8,260	4,568	35,178	5,271
Other expense, net	(12,279)	(52,108)	(2,170)	(52,194)
Loss before income taxes	(22,262)	(73,453)	(20,005)	(108,697)
Income tax (benefit) expense	(44)	1	(63)	5
Loss from continuing operations	(22,218)	(73,454)	(19,942)	(108,702)
Gain from discontinued operations	3,816	0	3,816	0
Net loss	$ (18,402)	$ (73,454)	$ (16,126)	$ (108,702)
Net loss per share from continuing operations, basic	$ (6.08)	$ (48.89)	$ (6.25)	$ (85.41)
Net loss per share from continuing operations, diluted	(6.08)	(48.89)	(6.25)	(85.41)
Net gain per share from discontinued operations, basic	1.04	0	1.2	0
Net gain per share from discontinued operations, diluted	1.04	0	1.2	0
Net loss per share, basic	(5.04)	(48.89)	(5.06)	(85.41)
Net loss per share, diluted	$ (5.04)	$ (48.89)	$ (5.06)	$ (85.41)
Weighted average shares outstanding, basic	3,652,862	1,502,473	3,189,308	1,272,765
Weighted average shares outstanding, diluted	3,652,862	1,502,473	3,189,308	1,272,765

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Deficit (Unaudited) - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Deficit	Treasury Stock
Beginning Balance at Dec. 31, 2022	$ (102,287)	$ 1	$ 743,633	$ (826,843)	$ (19,078)
Beginning Balance, shares at Dec. 31, 2022		909,881			(17,037)
Issuance of stock, net	12,524		12,524
Issuance of stock, net, shares		285,310
Issuance of common stock upon vesting of restricted stock units	(178)		(178)
Issuance of common stock upon vesting of restricted stock units, shares		14,632			(6,893)
Stock-based compensation expense	2,384		2,384
Net Income (Loss)	(17,441)			(17,441)
Ending Balance at Mar. 31, 2023	(104,998)	$ 1	758,363	(844,284)	$ (19,078)
Ending Balance, shares at Mar. 31, 2023		1,209,823			(23,930)
Beginning Balance at Dec. 31, 2022	(102,287)	$ 1	743,633	(826,843)	$ (19,078)
Beginning Balance, shares at Dec. 31, 2022		909,881			(17,037)
Net Income (Loss)	(108,702)
Ending Balance at Sep. 30, 2023	(118,786)	$ 2	835,835	(935,545)	$ (19,078)
Ending Balance, shares at Sep. 30, 2023		2,414,758			(73,664)
Beginning Balance at Mar. 31, 2023	(104,998)	$ 1	758,363	(844,284)	$ (19,078)
Beginning Balance, shares at Mar. 31, 2023		1,209,823			(23,930)
Issuance of stock, net, shares		150,943
Issuance of common stock upon vesting of restricted stock units	(90)		(90)
Issuance of common stock upon vesting of restricted stock units, shares		7,925			(2,682)
Stock-based compensation expense	2,014		2,014
Net Income (Loss)	(17,807)			(17,807)
Ending Balance at Jun. 30, 2023	(120,881)	$ 1	760,287	(862,091)	$ (19,078)
Ending Balance, shares at Jun. 30, 2023		1,368,691			(26,612)
Issuance of stock, net	10		10
Issuance of stock, net, shares		8,291
Issuance of common stock upon vesting of restricted stock units	(1,691)		(1,691)
Issuance of common stock upon vesting of restricted stock units, shares		114,248			(47,052)
Issuance of common stock upon conversion of debt	66,699	$ 1	66,698
Issuance of common stock upon conversion of debt, shares		923,528
Stock-based compensation expense	10,531		10,531
Net Income (Loss)	(73,454)			(73,454)
Ending Balance at Sep. 30, 2023	(118,786)	$ 2	835,835	(935,545)	$ (19,078)
Ending Balance, shares at Sep. 30, 2023		2,414,758			(73,664)
Beginning Balance at Dec. 31, 2023	(101,421)	$ 2	868,613	(950,958)	$ (19,078)
Beginning Balance, shares at Dec. 31, 2023		2,857,484			(73,736)
Issuance of stock, net	2,824		2,824
Issuance of stock, net, shares		259,158
Issuance of common stock upon vesting of restricted stock units, shares		13			(6)
Issuance of common stock warrants	1,062		1,062
Stock-based compensation expense	1,539		1,539
Net Income (Loss)	(4,189)			(4,189)
Ending Balance at Mar. 31, 2024	(100,185)	$ 2	874,038	(955,147)	$ (19,078)
Ending Balance, shares at Mar. 31, 2024		3,116,655			(73,742)
Beginning Balance at Dec. 31, 2023	(101,421)	$ 2	868,613	(950,958)	$ (19,078)
Beginning Balance, shares at Dec. 31, 2023		2,857,484			(73,736)
Net Income (Loss)	(16,126)
Ending Balance at Sep. 30, 2024	(106,629)	$ 3	879,530	(967,084)	$ (19,078)
Ending Balance, shares at Sep. 30, 2024		3,778,030			(100,304)
Beginning Balance at Mar. 31, 2024	(100,185)	$ 2	874,038	(955,147)	$ (19,078)
Beginning Balance, shares at Mar. 31, 2024		3,116,655			(73,742)
Issuance of stock, net	2,807	$ 1	2,806
Issuance of stock, net, shares		545,454
Issuance of common stock upon vesting of restricted stock units	(6)		(6)
Issuance of common stock upon vesting of restricted stock units, shares		6,797			(858)
Issuance of common stock warrants	24		24
Stock-based compensation expense	1,573		1,573
Net Income (Loss)	6,465			6,465
Ending Balance at Jun. 30, 2024	(89,322)	$ 3	878,435	(948,682)	$ (19,078)
Ending Balance, shares at Jun. 30, 2024		3,668,906			(74,600)
Issuance of stock, net	30		30
Issuance of stock, net, shares		52,581
Issuance of common stock upon vesting of restricted stock units	(171)		(171)
Issuance of common stock upon vesting of restricted stock units, shares		56,543			(25,704)
Issuance of common stock warrants	(45)		(45)
Stock-based compensation expense	1,281		1,281
Net Income (Loss)	(18,402)			(18,402)
Ending Balance at Sep. 30, 2024	$ (106,629)	$ 3	$ 879,530	$ (967,084)	$ (19,078)
Ending Balance, shares at Sep. 30, 2024		3,778,030			(100,304)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Operating Activities:
Net loss	$ (16,126)	$ (108,702)
Adjustments to reconcile net loss to net cash used in operating activities:
Gain from discontinued operations	(3,816)	0
Depreciation and amortization	326	438
Stock-based compensation expense	4,393	14,929
Loss on extinguishment of convertible notes	10,890	0
Inducement loss on convertible notes	0	53,198
Amortization of debt discount	3,216	1,126
Loss on disposal of property and equipment	10	12
Impairment of property and equipment	0	100
Change in fair value of derivative liabilities	(8,669)	0
Change in fair value of warrant liabilities	(35,178)	(5,271)
Changes in operating assets and liabilities:
Income tax receivable	(38)	10
Prepaid expenses and other assets	1,150	734
Accounts payable	3,389	287
Accrued expenses and other current liabilities	8,702	9,963
Other long-term liabilities	(427)	(1,578)
Net cash used in operating activities	(32,178)	(34,754)
Investing Activities:
Purchases of property and equipment	(214)	(37)
Proceeds from sale of property and equipment	20	11
Proceeds from sale of investment in Enumera Molecular, Inc.	3,000	0
Net cash provided by (used in) investing activities	2,806	(26)
Financing Activities:
Proceeds from issuance of common stock	6,465	13,064
Proceeds from issuance of common stock warrants	2,819	8,000
Proceeds from issuance of convertible notes, net	10,813	0
Payments of offering costs	(1,038)	(471)
Payments for financing of insurance premiums	(1,525)	(1,771)
Tax payments to settle restricted stock units	(177)	(1,959)
Net cash provided by financing activities	17,357	16,863
Net decrease in cash, cash equivalents and restricted cash	(12,015)	(17,917)
Cash, cash equivalents and restricted cash at beginning of period	15,211	30,486
Cash, cash equivalents and restricted cash at end of period	3,196	12,569
Supplemental disclosure of cash flow information:
Cash paid for interest	244	1,196
Cash paid for income taxes	61	14
Supplemental schedule of non-cash investing and financing activities:
Exchange of convertible notes for senior secured notes and warrants	5,625	0
Lease assets obtained in exchange for operating lease liabilities	0	1,344
Conversion of convertible notes	0	50,000
Offering costs incurred but not paid	635	59
Purchases of property and equipment in accounts payable	$ 161	$ 11

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2024	Sep. 30, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ (18,402)	$ 6,465	$ (4,189)	$ (73,454)	$ (17,807)	$ (17,441)	$ (16,126)	$ (108,702)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Sep. 30, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
Rule 10b5-1 Arrangement Modified	false
Non-Rule 10b5-1 Arrangement Modified	false

Organization and Description of

Organization and Description of Business	9 Months Ended
	Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Description of Business	1 . Organization and Description of Business Biora Therapeutics, Inc. (the “Company” or “Biora” or "Biora Therapeutics") is a clinical-stage biotechnology company developing oral biotherapeutics that could enable new treatment approaches in the delivery of therapeutics. The Company's pipeline includes two therapeutic delivery platforms: • NaviCap TM Targeted Oral Delivery Platform : Delivery of therapeutics to the site of disease in the gastrointestinal tract designed to improve outcomes for patients with Inflammatory Bowel Disease; and • BioJet TM Systemic Oral Delivery Platform : Designed to replace injections with needle-free delivery of large molecules. Our mission is to reimagine therapeutics and their delivery by creating innovative smart pills designed for targeted drug delivery to the GI tract and needle-free, oral delivery of biotherapeutics. Biora Therapeutics, a Delaware corporation, commenced operations in 2010 with its corporate office located in San Diego, California. The Company was previously known as Progenity, Inc., and its historical operations included a licensed Clinical Laboratory Improvement Amendments and College of American Pathologists certified laboratory located in Michigan focused on genetic carrier screening and noninvasive prenatal testing, serving women’s health providers in the obstetric, gynecological, fertility, and maternal fetal medicine specialty areas in the United States. Through its former affiliation with Mattison Pathology, LLP, a Texas limited liability partnership doing business as Avero Diagnostics (“Avero”), the Company’s operations also included anatomic and molecular pathology testing products. On December 29, 2022, the Company filed a certificate of amendment (the "Certificate of Amendment") to its eighth amended and restated certificate of incorporation to effect, as of January 3, 2023, a 1-for-25 reverse split of the Company's common stock (the "2023 Reverse Stock Split"). On January 3, 2023, the Company effected the 2023 Reverse Stock Split. On October 10, 2024, the Company filed a certificate of amendment to its eighth amended and restated certificate of incorporation to effect, as of October 18, 2024, a 1-for-10 reverse split of the Company's common stock (the "2024 Reverse Stock Split"). On October 18, 2024, the Company effected the 2024 Reverse Stock Split. See Note 2 for additional information. Liquidity As of September 30, 2024, the Company had cash and cash equivalents of $ 3.0 million, restricted cash of $ 0.2 million and a working capital deficit. The Company had an accumulated deficit of $ 967.1 million as of September 30, 2024. For the nine months ended September 30, 2024, the Company reported net loss of $ 16.1 million and cash used in operating activities of $ 32.2 million. The Company’s primary sources of capital have historically been the sale of common stock and warrants, private placements of preferred stock and the incurrence of debt. As of September 30, 2024, the Company had a face value of $ 58.3 million of 11.0 %/ 13.0 % convertible senior secured notes due 2028 ("2028 Convertible Notes") outstanding and a face value of $ 4.6 million of 7.25 % convertible senior notes due 2025 ("2025 Convertible Notes" and together with the 2028 Con vertible Notes, the "Convertible Notes") outstanding (see Note 6). Management does not expect that the Company's current cash and cash equivalents will be sufficient to fund its operations for at least 12 months from the issuance date of the condensed consolidated financial statements for the three and nine months ended September 30, 2024, and will require additional capital to fund the Company's operations. As a result, substantial doubt exists about the Company’s ability to continue as a going concern for 12 months following the issuance date of the condensed consolidated financial statements for the three and nine months ended September 30, 2024. The Company’s ability to continue as a going concern is dependent upon its ability to raise additional funding. Management intends to raise additional capital through equity offerings and/or debt financings, or from other potential sources of liquidity, which may include new collaborations, licensing or other commercial agreements for one or more of the Company’s research programs or patent portfolios or divestitures of the Company's assets. Adequate funding, if needed, may not be available to the Company on acceptable terms, or at all. The Company’s ability to raise additional funds may be adversely impacted by potential worsening global economic conditions and the disruptions to, and volatility in, the credit and financial markets in the United States and worldwide. If the Company is unable to raise capital when needed or on attractive terms, it would be forced to delay, reduce, or eliminate its research and development programs or other operations. If any of these events occur, the Company’s ability to achieve its operational goals would be adversely affected. As of September 30, 2024 and through the date of this filing, the Company was in compliance with its debt and related covenants (see Note 6). However, based on the Company’s cash and cash equivalents balance and its forecasted business plan over the next twelve months, indications suggest that such forecasts are unlikely to be sufficient for the Company to be able to continue to maintain compliance with the financial covenants under its debt agreements for at least twelve months from the issuance of the accompanying unaudited consolidated financial statements. Failure to meet these covenant requirements in the future would cause the Company to be in default and could cause the maturity of the Convertible Notes to be accelerated and become immediately payable absent obtaining additional waivers or negotiating additional amendments to avoid acceleration. As a result, all Convertible Notes and related derivative liabilities have been reclassified to current on the condensed consolidated balance sheet as of September 30, 2024 .

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2024
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2 . Summary of Significant Accounting Policies Basis of Presentation The Company’s condensed consolidated financial statements have been prepared in conformity with accounting principles generally accepted in the United States of America (“GAAP”) for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. These financial statements should be read in conjunction with the Company’s audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023, as filed with the Securities and Exchange Commission, from which management derived the Company’s condensed consolidated balance sheet as of December 31, 2023. The condensed consolidated financial statements and notes thereto give retrospective effect to the 2023 Reverse Stock Split and the 2024 Reverse Stock Split for all periods presented. All common stock, options exercisable for common stock, restricted stock units ("RSUs"), warrants and per share amounts contained in the condensed consolidated financial statements have been retrospectively adjusted to reflect the 2023 Reverse Stock Split and the 2024 Reverse Stock Split for all periods presented. Unaudited Interim Financial Information The accompanying condensed consolidated financial statements are unaudited, have been prepared on the same basis as the audited annual financial statements and, in the opinion of management, reflect all adjustments, consisting of normal recurring adjustments, that are necessary to present fairly the results for the interim periods presented. Results are not necessarily indicative of results to be expected for the year ending December 31, 2024, any other interim periods, or any future year or period. The balance sheet as of December 31, 2023 included herein was derived from the audited financial statements as of that date. Certain disclosures have been condensed or omitted from the interim financial statements. Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities as of the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Significant items subject to such estimates include the valuation of stock options, the valuation of goodwill, the valuation of the derivative liabilities associated with the 2028 Convertible Notes, accrual for reimbursement claims and settlements, the valuation of warrant liabilities, assessing future tax exposure and the realization of deferred tax assets, and the useful lives and the recoverability of property and equipment. The Company bases these estimates on historical and anticipated results, trends, and various other assumptions that the Company believes are reasonable under the circumstances, including assumptions as to future events. These estimates form the basis for making judgments about the carrying values of assets and liabilities and recorded revenues and expenses that are not readily apparent from other sources. Actual results could differ from those estimates and assumptions. Restricted Cash Restricted cash consists of collateral required for the Company's bank-issued credit cards with a balance of $ 0.2 million as of both September 30, 2024 and December 31, 2023 . Recent Accounting Pronouncements Adopted In August 2020, the Financial Accounting Standards ("FASB") issued Accounting Standards Update ("ASU") No. 2020-06 , Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging-Contracts in Entity's Own Equity (Subtopic 815-40)—Accounting for Convertible Instruments and Contracts in an Entity's Own Equity , which simplifies the accounting for convertible instruments, amends the guidance on derivative scope exceptions for contracts in an entity's own equity, and modifies the guidance on diluted earnings per share calculations as a result of these changes. The standard is effective for the Company for annual reporting periods beginning after December 15, 2023. The Company adopted this standard on January 1, 2024, and it did not have a material impact on the consolidated financial statements. Recent Accounting Pronouncements Not Yet Adopted In December 2023, the FASB issued ASU No. 2023-09, Improvements to Income Tax Disclosures , which introduces new and enhanced income tax disclosure requirements. The standard is effective for the Company for annual reporting periods beginning after December 15, 2024. The Company is currently evaluating the impact the adoption of this standard may have on its consolidated financial statements and related disclosures.

Strategic Transformation

Strategic Transformation	9 Months Ended
	Sep. 30, 2024
Discontinued Operations and Disposal Groups [Abstract]
Strategic Transformation	3. Strategic Transformation In order to refocus efforts and resources on its research and development pipeline, in June 2021, the Company announced a strategic transformation ("Strategic Transformation") that included the closure of the legacy genetics laboratory and the sale of Avero, (collectively, the "Laboratory Operations"). The Company classified the results of its Laboratory Operations as discontinued operations in its condensed consolidated statements of operations and consolidated statements of cash flows. The following table presents the combined results of discontinued operations of the Laboratory Operations for the three and nine months ended September 30, 2024 (in thousands); there was no gain or loss from discontinued operations for the three and nine months ended September 30, 2023: Three Months Ended Nine Months Ended September 30, 2024 Revenues $ — $ — Operating expenses: Selling, general and administrative (1) ( 3,816 ) ( 3,816 ) Total operating expenses ( 3,816 ) ( 3,816 ) Net gain from discontinued operations $ 3,816 $ 3,816 (1) Related to the reversal of amounts that were expensed in discontinued operations in 2021 and settled for a lower amount during the three months ended September 30, 2024. Assets Held for Sale In October 2023, the Company entered into a purchase and sale agreement to sell the building located in Ann Arbor, Michigan included in current assets held for sale. The transaction closed in October 2023 and the Company received gross proceeds of $ 2.8 million and incurred closing expenses of $ 0.2 million. There were no assets held for sale as of September 30, 2024 or December 31, 2023. Investment in Enumera Molecular, Inc. In May 2022, the Company completed the divesture of its single-molecule detection platform. Under the terms of the agreements, the Company contributed intellectual property and fixed assets related to the single-molecule detection platform to a newly-formed entity, Enumera Molecular, Inc. ("Enumera"), which intends to develop and commercialize the platform. On the transaction date, the Company received a 25 % minority ownership stake, on a fully-diluted basis, of 6,000,000 Series A-1 preferred shares with an estimated value of $ 6.0 million in exchange for the assets. The Company concluded, based on a technical evaluation of the facts, that Enumera is not a variable interest entity. The Company also evaluated the characteristics of the investment and determined that the preferred stock is not in-substance common stock that would require equity method accounting. The Company concluded the appropriate accounting treatment for the investment in Enumera to be that of an equity security with no readily determinable fair value and has recorded the investment at cost, less impairment, adjusted for subsequent observable price changes. The Company determined the fair value was less than carrying value as of December 31, 2023 based on negative cash flows from operations and for the year ended December 31, 2023 recorded a $ 3.0 million impairment loss on its investment. The investment is included in other assets in the Company’s condensed consolidated balance sheets as of December 31, 2023 . In March 2024, the Company entered into a stock purchase agreement with Enumera investors, pursuant to which it sold its remaining investment for $ 3.0 million. Licensing Agreements In June 2023, the Company entered into a purchase and license agreement with a diagnostics company pursuant to which the Company sold certain assets and licensed intellectual property related to preeclampsia for research and development (the “Preeclampsia Agreement”). Under the terms of the Preeclampsia Agreement, the Company received a one-time payment for the sale of assets, including the sale of rights to certain antibody sequences, and recorded $ 1.5 million of other income during the three months ended September 30, 2023. In May 2023, the Company entered into a professional services agreement with an affiliate of Enumera, a related party. Pursuant to the agreement, the affiliate assisted in selling legacy assets. The Company incurred $ 0.4 million during the three months ended September 30, 2023 recorded in other expenses in connection with the agreement. In November 2022, the Company entered into a license agreement with Northwest Pathology, doing business as Avero Diagnostics (“Northwest”), pursuant to which the Company licensed its Preecludia rule-out test for preeclampsia to Northwest for commercial development (the “Northwest License Agreement”). Under the terms of the Northwest License Agreement, Northwest received the rights to assets and intellectual property related to the Preecludia test and the Company would receive commercial milestone payments and royalties on net sal es.

Balance Sheet Components

Balance Sheet Components	9 Months Ended
	Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Balance Sheet Components	4 . Balance Sheet Components Prepaid Expenses and Other Current Assets Prepaid expenses and other current assets consisted of the following (in thousands): September 30, December 31, Prepaid expenses $ 1,945 $ 2,443 Other current assets 45 587 Total $ 1,990 $ 3,030 Property and Equipment, Net Property and equipment, net consisted of the following (in thousands): September 30, December 31, Computers and software $ 1,210 $ 1,193 Building and leasehold improvements 852 803 Laboratory equipment 714 423 Furniture, fixtures, and office equipment 799 799 Construction in progress 5 45 Total property and equipment 3,580 3,263 Less accumulated depreciation and amortization ( 2,405 ) ( 2,107 ) Property and equipment, net $ 1,175 $ 1,156 Depreciation and amortization expense was $ 0.1 million and $ 0.3 million for the three and nine months ended September 30, 2024, respectively, and $ 0.1 million and $ 0.4 million for the three and nine months ended September 30, 2023, respectively. Other Assets Other assets consisted of the following (in thousands): September 30, December 31, Investment in Enumera $ — $ 3,000 Other 193 302 Total $ 193 $ 3,302 Accrued Expenses and Other Current Liabilities Accrued expenses and other current liabilities consisted of the following (in thousands): September 30, December 31, Accrual for reimbursement claims and legal settlements, current (1) $ 3,572 $ 6,337 Accrued legal fees (2) 9,397 1,577 Commissions and bonuses 3,423 2,469 Vacation and payroll benefits 1,437 1,367 Accrued professional services 576 1,337 Accrued interest 1,439 173 Lease liabilities, current 717 896 Insurance financing 751 401 Contract liabilities — 542 Other (3) 92 2,220 Total $ 21,404 $ 17,319 (1) Laboratory Operations have been discontinued; amounts related to revenue reserves generated from the Laboratory Operations remain on the balance sheet. (2) The Company entered into an alternative fee arrangement with a professional services firm related to certain litigation matters; amounts related to the arrangement are included in accrued legal fees. (3) Included in the December 31, 2023 amount are contracts that the Company was responsible for that were expensed in discontinued operations in 2021. Other Long-term Liabilities Other long-term liabilities consisted of the following (in thousands): September 30, December 31, Lease liabilities, net of current portion 337 818 Other (1) 179 2,211 Total $ 516 $ 3,029 (1) Included in the December 31, 2023 amount are contracts that the Company was responsible for that were expensed in discontinued operations in 2021.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2024
Fair Value Disclosures [Abstract]
Fair Value Measurements	5 . Fair Value Measurements Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability (an exit price) in an orderly transaction between market participants at the measurement date. The authoritative guidance establishes a three-level valuation hierarchy that prioritizes the inputs to valuation techniques used to measure fair value based upon whether such inputs are observable or unobservable. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect market assumptions made by the reporting entity. This hierarchy requires the Company to use observable market data, when available, and to minimize the use of unobservable inputs when determining fair value. The three-level hierarchy for the inputs to valuation techniques is summarized as follows: Level 1 - Quoted prices in active markets for identical assets and liabilities that the Company has the ability to access. Level 2 - Observable market-based inputs or unobservable inputs that are corroborated by market data, such as quoted prices, interest rates, and yield curves. Level 3 - Inputs that are unobservable data points that are not corroborated by market data. There were no significant transfers between these fair value measurement classifications during the nine months ended September 30, 2024 and 2023. The following table presents information about the Company’s assets and liabilities that are measured at fair value on a recurring basis and indicates the fair value hierarchy of the valuation techniques utilized to determine such fair value (in thousands): Level 1 Level 2 Level 3 September 30, 2024 Derivative liabilities $ — $ — $ 35,018 Warrant liabilities $ — $ — $ 18,688 December 31, 2023 Derivative liabilities $ — $ — $ 22,899 Warrant liabilities $ — $ — $ 40,834 The Company issued 2028 Convertible Notes (see Note 6 ) that contain conversion features that are required to be bifurcated and recorded as embedded derivative liabilities in the consolidated balance sheet. The Company utilized a binomial pricing model to determine the fair value of the conversion features, which utilizes significant unobservable inputs. The fair value of the embedded derivatives as of September 30, 2024 and December 31, 2023 were estimated using a binomial pricing model with the following inputs and assumptions: September 30, December 31, Risk-free interest rate 3.5 % 3.8 % - 4.3 % Expected volatility 91.9 % 84.3 % - 95.7 % Stock price $ 5.00 $ 13.50 Discount rate 40.7 % 28.7 % - 28.9 % The Company’s Level 3 liabilities consist of the warrant liabilities resulting from equity financings (see Note 9) and the Convertible Note exchanges (see Note 6). The Company uses the Black-Scholes Model to value the warrant liabilities at inception and on subsequent valuation dates. This model incorporates transaction details such as the Company’s stock price, contractual terms, maturity, risk free rates, and volatility. The significant unobservable input for the Level 3 warrant liabilities includes volatility. Given the limited period of time the Company’s stock has been traded in an active market, the expected volatility is estimated by taking the average historical price volatility for industry peers, consisting of several public companies in the Company’s industry that are similar in size, stage, or financial leverage, over a period of time comme nsurate to the expected term of the warrants. At September 30, 2024 and December 31, 2023, the fair value of the warrant liabilities were estimated using the Black-Scholes Model with the following inputs and assumptions: September 30, December 31, Risk-free interest rate 3.6 % - 3.7 % 3.8 % - 4.1 % Expected volatility 76.3 % - 94.7 % 95.6 % - 101.8 % Stock price $ 5.00 $ 13.50 Expected life (years) 1.9 - 5.0 2.5 - 5.0 The Company estimated the fair value of the warrants amended as part of the August Debt Exchange Transactions (defined below) using a Monte Carlo simulation to value the warrant liabilities at the amendment date and on subsequent valuation dates. The Monte Carlo simulation-pricing model incorporates transaction details such as the Company’s stock price, contractual terms, maturity, risk free rates, and volatility. The significant unobservable input for the Level 3 warrant liabilities includes volatility. Given the limited period of time the Company’s stock has been traded in an active market, the expected volatility is estimated by taking the average historical price volatility for industry peers, consisting of several public companies in the Company’s industry that are similar in size, stage, or financial leverage, over a period of time commensurate to the expected term of the warrants. At September 30, 2024, the fair value of the warrant liabilities were estimated using the Monte Carlo simulation with the following inputs and assumptions: September 30, Risk-free interest rate 3.6 % Expected volatility 93.5 % - 94.2 % Stock price $ 5.00 Expected life (years) 3.9 - 5.0 A summary of the changes in the Level 3 classified liabilities is presented below (in thousands): Warrant Liabilities Derivative Liabilities Balance at December 31, 2023 $ 40,834 $ 22,899 Recognition of warrant liabilities 11,405 — Reclassification of warrant liabilities to equity ( 1,062 ) — Reclassification to warrant liabilities from equity 45 — Expired warrants ( 1,460 ) — Warrant reprice adjustment 4,938 — Extinguishment of derivative liabilities — ( 37,040 ) Recognition of derivative liabilities — 57,828 Change in fair value ( 36,012 ) ( 8,669 ) Balance at September 30, 2024 $ 18,688 $ 35,018

Convertible Notes

Convertible Notes	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Convertible Notes	6. Convertible Notes The following table summarizes significant terms of the Company's Convertible Notes at September 30, 2024 (in thousands): September 30, 2024 Face Value Carrying Value Fair Value (1) Stated Interest Rate Effective Interest Rate Non-Affiliate 2028 Convertible Notes (2) $ 39,901 $ 14,344 $ 14,807 11 - 13 % 50.9 % Related Party 2028 Convertible Notes (3) $ 18,400 $ 19,721 $ 5,853 11 - 13 % 24.7 % 2025 Convertible Notes $ 4,600 $ 4,527 $ 2,676 7.25 % 8.7 % (1) To estimate the fair value of the Non-Affiliate 2028 Convertible Notes, the Company used a binomial pricing model. Including the derivative liabilities of $ 23.0 million, the Non-Affiliate 2028 Convertible Notes fair value using the with method is $ 37.8 million. To estimate the fair value of the Related Party 2028 Convertible Notes, the Company used a binomial pricing model. Including the derivative liabilities of $ 12.1 million, the Non-Affiliate 2028 Convertible Notes fair value using the with method is $ 17.9 million. To estimate the fair value of the 2025 Convertible Notes, the Company used unadjusted quoted prices in the active market obtained from third-party pricing services. (2) The face value includes $ 24.0 million in Payment Priority Notes (as defined below) and $ 1.8 million in PIK Notes (as defined below). (3) The face value includes $ 5.5 million in Payment Priority Notes (as defined below) and $ 1.0 million in PIK Notes (as defined below). The following table summarizes significant terms of the Company’s Convertible Notes at December 31, 2023 (in thousands): December 31, 2023 Face Value Carrying Value Fair Value (4) Stated Interest Rate Effective Interest Rate Non-Affiliate 2028 Convertible Notes $ 23,500 $ 14,591 $ 14,846 11 - 13 % 48.9 % Related Party 2028 Convertible Notes $ 17,383 $ 21,155 $ 10,982 11 - 13 % ( 22.0 )% 2025 Convertible Notes $ 10,225 $ 9,966 $ 5,984 7.25 % 8.7 % (4) To estimate the fair value of the 2028 Convertible Notes, the Company used a binomial pricing model. Including the derivative liabilities of $ 22.9 million, the 2028 Convertible Notes fair value using the with method is $ 48.7 million. To estimate the fair value of the 2025 Convertible Notes, the Company used unadjusted quoted prices in the active market obtained from third-party pricing services. As discussed in Note 1, while the Company was in compliance with its debt and related covenants as of September 30, 2024 and through the date of this filing, indications suggest that the Company may not be able to continue to maintain compliance with the financial covenants under its debt agreements for at least the next twelve months. As a result, all Convertible Notes and related derivative liabilities have been reclassified to current on the condensed consolidated balance sheet as of September 30, 2024. The carrying value of the Convertible Notes does not approximate their fair values because the carrying values reflect the balance of unamortized discount related to the derivative liabilities associated with the value of the conversion features assessed at inception. The Company amortizes the debt discount using the effective interest method over the term of the Convertible Notes. As of September 30, 2024 and December 31, 2023, the unamortized debt discount on the 2025 Convertible Notes was $ 0.1 million and $ 0.3 million, respectively. The amortization of the debt discount was less than $ 0.1 million and $ 0.4 million for the three months ended September 30, 2024 and 2023, respectively, and $ 0.1 million and $ 1.1 million for the nine months ended September 30, 2024 and 2023, respectively, and is included in interest expense, net in the consolidated statements of operations. As of September 30, 2024 and December 31, 2023, the unamortized debt discount on the 2028 Convertible Notes was $ 43.4 million and $ 19.0 million, respectively. The amortization of the debt discount was $ 0.9 million and $ 3.2 million for the three and nine months ended September 30, 2024, respectively, and is included in interest expense, net in the consolidated statements of operations. 2025 Convertible Notes In December 2020, the Company issued a total of $ 168.5 million principal amount of 2025 Convertible Notes in a private offering of the Convertible Notes pursuant to Rule 144A under the Securities Act of 1933, as amended (the "Securities Act"). The 2025 Convertible Notes were issued pursuant to, and are governed by, an indenture, dated as of December 7, 2020 , by and between the Company and The Bank of New York Mellon Trust Company, N.A., as trustee (the “2025 Convertible Notes Indenture”). The 2025 Convertible Notes are due on December 1, 2025 , unless earlier repurchased, redeemed or converted, and accrue interest at a rate per annum equal to 7.25 % payable semi-annually in arrears on June 1 and December 1 of each year, with the initial payment on June 1, 2021 . The Company recognized interest expense on the 2025 Convertible Notes of $ 0.1 million and $ 0.3 million for the three and nine months ended September 30, 2024, respectively, and $ 2.3 million and $ 7.1 million for the three and nine months ended September 30, 2023, respectively. The 2025 Convertible Notes are the Company's senior, unsecured obligations and are (i) equal in right of payment with the Company's existing and future senior, unsecured indebtedness; (ii) senior in right of payment to the Company's existing and future indebtedness that is expressly subordinated to the 2025 Convertible Notes; (iii) effectively subordinated to the Company's existing and future secured indebtedness, to the extent of the value of the collateral securing that indebtedness; and (iv) structurally subordinated to all existing and future indebtedness and other liabilities, including trade payables, and (to the extent the Company is not a holder thereof) preferred equity, if any, of the Company's subsidiaries. At any time, noteholders may convert their 2025 Convertible Notes at their option into shares of the Company’s common stock, together, if applicable, with cash in lieu of any fractional share, at the then-applicable conversion rate. The initial conversion rate is 1.11204 shares of common stock per $1,000 principal amount of 2025 Convertible Notes, which represents an initial conversion price of approximately $ 899.25 per shar e of common stock. Noteholders that converted their 2025 Convertible Notes before December 1, 2022 were, in certain circumstances, entitled to an additional cash payment representing the present value of any remaining interest payments on the 2025 Convertible Notes through December 1, 2022. The conversion rate and conversion price are subject to customary adjustments upon the occurrence of certain dilutive events. In addition, if certain corporate events that constitute a “Make-Whole Fundamental Change” (as defined in the 2025 Convertible Notes Indenture) occur, then the conversion rate will, in certain circumstances, be increased for a specified period of time. The 2025 Convertible Notes are redeemable, in whole and not in part, at the Company’s option at any time on or after December 1, 2023 , at a cash redemption price equal to the principal amount of the 2025 Convertible Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date, but only if the last reported sale price per share of the Company’s common stock exceeds 130 % of the conversion price on (i) each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and including, the trading day immediately before the date the Company sends the related redemption notice; and (ii) the trading day immediately before the date the Company sends such notice. In addition, calling the 2025 Convertible Notes will constitute a Make-Whole Fundamental Change, which will result in an increase to the conversion rate in certain circumstances for a specified period of time. If certain corporate events that constitute a “Fundamental Change” (as defined in the 2025 Convertible Notes Indenture) occur, then noteholders may require the Company to repurchase their 2025 Convertible Notes at a cash repurchase price equal to the principal amount of the 2025 Convertible Notes to be repurchased, plus accrued and unpaid interest, if any, to, but excluding, the fundamental change repurchase date. The definition of Fundamental Change includes certain business combination transactions involving the Company and certain de-listing events with respect to the Company’s common stock, including delisting from the Nasdaq Global Market. The 2025 Convertible No tes have customary provisions relating to the occurrence of “Events of Default” (as defined in the 2025 Convertible Notes Indenture). As of both September 30, 2024 and December 31, 2023, the Company was in compliance with all such covenants. The 2025 Convertible Notes had a conversion option which was required to be bifurcated upon issuance and recorded separately as an embedded derivative remeasured at fair value each reporting period with changes in fair value recorded in the consolidated statement of operations. As of December 31, 2022, the conversion option expired and there was no longer a derivative liability. Note Exchanges In September 2023, certain related party holders of 2025 Convertible Notes exchanged an aggregate of $ 50.0 million principal amount for a combination of 923,528 shares of the Company's common stock, 739,921 pre-funded warrants at an exercise price of $ 0.01 per share and warrants to purchase up to 1,663,449 shares of common stock at an exercise price of $ 30.10 per share . The warrants are exercisable on or after September 18, 2023 until September 18, 2026 and t he pre-funded warrants have no expiration date. T he pre-funded warrants and the warrants (together, the "September 2023 Warrants") are subject to certain exercise limitations, including a limitation on the ability to exercise if the holder’s beneficial ownership would exceed 49.9 %. As the 2025 Convertible Notes were exchanged for an amount over the fair value of shares issuable under the original conversion terms, the Company recorded an inducement loss of $ 53.2 million, included in other expense , net in the condensed consolidated statements of operations. Pursuant to Accounting Standards Codification ("ASC") Topic 815, Derivatives and Hedging ("ASC 815") the Company deemed the September 2023 Warrants to be classified as a liability at fair value initially with subsequent changes in fair value recorded in earnings. The September 2023 Warrants were recorded at a fair value of $ 35.1 million determined using the Black-Scholes Model. In December 2023, the Company entered into exchange agreements with certain holders of 2025 Convertible Notes to exchange an aggregate of $ 72.5 million principal amount for a combination of (i) $ 23.9 million in principal amount of 2028 Convertible Notes (ii) 62,500 shares of the Company's common stock, (iii) warrants to purchase 503,922 shares of common stock (the “Exchange Warrants”), and (iv) accrued and unpaid interest on the 2025 Convertible Notes. The Company also entered into note purchase agreements with certain investors (the "Purchasers") to purchase $ 17.0 million in principal amount of additional 2028 Convertible Notes from the Company for cash at par value. The Purchasers were granted warrants to purchase 508,460 shares of common stock (the “Additional Warrants”) and certain Purchasers were also granted warrants to purchase 735,292 shares of common stock (the “Commitment Warrants”). In connection with these agreements, the Company has agreed to allow certain of the parties to designate one observer to the Company's Board of Directors (the "Board"). The Exchange Warrants have an exercise price of $ 55.00 per share , are exercisable any time on or after December 19, 2023 and expire on December 19, 2028 , the Commitment Warrants have an exercise price of $ 13.60 per share , are exercisable at any time on or after June 19, 2024 and expire on December 19, 2028 , and the Additional Warrants have an exercise price of $ 50.00 per share, are exercisable any time on or after December 19, 2023 and expire on December 19, 2028 . Each of the Exchange Warrants, the Commitment Warrants and the Additional Warrants (together the "December 2023 Warrants") are subject to certain exercise limitations, including a limitation on the ability to exercise if the holder’s beneficial ownership of common stock would exceed specified levels. Pursuant to ASC 815, the December 2023 Warrants are classified as a liability at fair value initially with subsequent changes in fair value recorded in earnings. In connection with the March 2024 Offering (as defined below), 232,205 of the December 2023 Warrants were amended to (i) lower the exercise price to $ 11.00 per share , (ii) provide that the warrants were not exercisable until June 5, 2024 (the "Stockholder Approval Date") and (iii) extend the original expiration date to be five year s from the Stockholder Approval Date. The December note exchange with one holder of 2025 Convertible Notes constitutes a troubled debt restructuring ("TDR") under ASC Topic 470, Debt ("ASC 470") because the Company is experiencing financial difficulty and a concession has been granted by the holder. As the holder is a related party, the Company recorded the restructuring gain as a capital contribution resulting in $ 25.5 million of restructuring gain recorded within additional paid-in-capital as of December 31, 2023. Following the TDR guidance under ASC 470, future interest payments of approximately $ 11.7 million were also included in the carrying value of the 2028 Convertible Notes. The December note exchange with the other holders of 2025 Convertible Notes is considered a debt extinguishment under ASC 470. As a result, the Company recorded a loss on debt extinguishment of $ 6.4 million, which is the difference between the fair value of the 2028 Convertible Notes combined with the fair value of the warrants, derivative liabilities and common stock and the net carrying value of the 2025 Convertible Notes during the fourth quarter of 2023. On March 8, 2024 the Company entered into an exchange agreement with a holder of the Company’s 2025 Convertible Notes, pursuant to which the Company agreed to acquire an aggregate of $ 5.6 million of 2025 Convertible Notes from the holder in exchange for (i) $ 3.8 million in aggregate principal amount of 2028 Convertible Notes, and (ii) accrued and unpaid interest on the 2025 Convertible Notes exchanged. The Company also entered into a note purchase agreement with the investor pursuant to which the investor agreed to purchase $ 2.8 million in aggregate principal amount of 2028 Convertible Notes from the Company for cash at par value. Additionally, as part of the agreements, the investor was granted warrants to purchase 200,000 shares of common stock. The warrants have an exercise price of $ 27.50 per share , are exercisable at any time on or after September 12, 2024 and expire on March 12, 2029 . The warrants are subject to certain exercise limitations, including a limitation on the ability to exercise if the holder’s beneficial ownership of common stock would exceed specified levels. Pursuant to ASC 815, the warrants are classified as a liability at fair value initially with subsequent changes in fair value recorded in earnings. The exchange is considered a debt extinguishment under ASC 470. As a result, the Company recorded a loss on debt extinguishment of $ 0.2 million, which is the difference between the fair value of the 2028 Convertible Notes combined with the fair value of the warrants, derivative liabilities and the net carrying value of the 2025 Convertible Notes. 2028 Convertible Notes The 2028 Convertible Notes were issued pursuant to, and are governed by, an indenture (the “2028 Convertible Notes Indenture”), dated December 19, 2023 , by and between the Company and GLAS Trust Company LLC, as trustee. The 2028 Convertible Notes will mature on the earlier of December 19, 2028 and the date that is 90 days prior to the maturity of the Convertible Notes solely to the extent there are Convertible Notes outstanding in a principal amount equal to or greater than $ 5.0 million as of such date, unless earlier repurchased, redeemed or converted. In March 2024, the maturity date of the Convertible Notes was extended to December 19, 2028 . The Notes will accrue interest at a rate of 11.0 % per annum in the case of cash payment and 13.0 % in the case of blended payments or payments-in-kind, payable semi-annually in arrears on June 1 and December 1 of each year, with the initial payment on June 1, 2024 . The Company recognized interest expense on the 2028 Convertible Notes of $ 1.0 million and $ 2.5 million for the three and nine months ended September 30, 2024, respectively. In May 2024, the Company entered into an agreement with holders of the Company's 2028 Convertible Notes for payment in kind interest in the form of additional 11.00 %/ 13.00 % Notes (“PIK Notes”). The payment was made to the holders by issuing additional 2028 Convertible Notes in an amount equal to the interest payment obligation of approximately $ 2.8 million for the payment date occurring on June 1, 2024. On July 3, 2024, the Company entered into a letter agreement (the "Forbearance Agreement) with the holders of the 2028 Convertible Notes pursuant to which, in exchange for the holders agreeing to forbear, until July 31, 2024, from exercising or enforcing certain rights and remedies against the Company under the terms of the 2028 Convertible Notes Indenture as a result of the Company's potential failure to comply with minimum liquidity requirement of Section 3.13 thereof, the Company issued to the holders 124,996 warrants to purchase shares of common stock (the “Forbearance Warrants”). The Forbearance Warrants have an exercise price of $ 6.30 per share and are exercisable at any time on or after July 3, 2024 and expire in October 2029 . On August 12, 2024 the Company entered into an exchange agreement (the “Exchange Agreement") with holders (each, a “Holder”) of the Company’s 2028 Convertible Notes, pursuant to which the Company agreed to acquire an aggregate of $ 10.8 million of principal amount, plus accrued and unpaid interest, of the existing 2028 Convertible Notes in exchange for $ 10.8 million of a series of a new tranche of 2028 Convertible Notes ("Payment Priority Notes") on August 15, 2024 ("the Initial Closing Date"). The Payment Priority Notes are the Company’s senior secured obligations with payment priority over the existing 2028 Convertible Notes. The Company also entered into note purchase agreements with the Holders (together with the Exchange Agreement, the "Debt Exchange Transactions") to purchase $ 16.0 million in aggregate principal amount of Payment Priority Notes from the Company for cash at par value on the Initial Closing Date. Once per month, up to three times, the Company may request that the Holders purchase additional Payment Priority Notes (a “Subsequent Draw”) with a purchase price of $ 4.0 million in a subsequent clos ing for a maximum amount of $ 16.0 million. To the extent that a Holder acquires additional Payment Priority Notes pursuant to a Subsequent Draw, each Holder shall have the right to exchange additional 2028 Convertible Notes for a series of Payment Priority Notes concurrently with the closin g of such Subsequent Draw. Additionally, as part of the agreements, the Holders were granted warrants to purchase 677,777 shares of common stock with an exercise price of $ 6.00 at the initial closing and will be granted additional warrants to purchase shares of common stock to in connection with Subsequent Draws. In connection with the Exchange Agreement, the Company also agreed to amend an aggregate of 2,291,445 outstanding warrants held by Holders to lower the exercise price to $ 6.00 per share. The Debt Exchange Transaction with a related party holder (see Note 7) constitutes a TDR under ASC 470 . No restructuring gain was recorded because the net carrying amount of 2028 Convertible Notes was less than the undiscounted future cashflows of the restructured Notes. The Debt Exchange Transactions with two of the Holders were considered debt extinguishments under ASC 470. As a result, the Company recorded a loss on debt extinguishment of $ 8.7 million for the three and nine months ended September 30, 2024. The Debt Exchange Transaction with the fourth Holder was considered a debt modification under ASC 470. In September 2024, as part of the Debt Exchange Transactions signed in August 2024 (the "September Drawdown"), the Holders purchased an additional $ 4.0 million aggregate principal amount of Payment Priority Notes and were granted warrants to purchase an aggregate of 675,552 shares of common stock with an exercise price of $ 6.00 per share. Additionally, the Company acquired an aggregate of $ 10.8 million principal amount, plus accrued and unpaid interest thereon, of the existing 2028 Notes in exchange for $ 10.8 million Payment Priority Notes. The September Drawdown with a related party holder (see Note 7 ) constitutes a TDR under ASC 470. No restructuring gain was recorded because the net carrying amount of 2028 Convertible Notes was less than the undiscounted future cashflows of the restructured Notes. The September Drawdown with the other Holders was considered a debt extinguishment under ASC 470. As a result, the Company recorded a loss on debt extinguishment of $ 2.0 million for the three and nine months ended September 30, 2024. In connection with the Debt Exchange Transactions, the Company amended and restated the 2028 Convertible Notes Indenture (as so amended and restated, the “A&R Indenture”). The 2028 Convertible Notes are the Company’s senior secured obligations, and are secured by substantially all of the Company’s and its subsidiaries’ assets. The 2028 Convertible Notes are (i) senior in right of payment to the Company’s existing and future senior, unsecured indebtedness to the extent of the value of the collateral; and (ii) senior in right of payment to the Company’s existing and future indebtedness that is expressly subordinated to the 2028 Convertible Notes. At any time, noteholders may convert their 2028 Convertible Notes at their option into shares of the Company’s common stock, together, if applicable, with cash in lieu of any fractional share, at the then-applicable conversion rate. The initial conversion rate is 64.1026 shares of common stock per $1,000 principal amount of 2028 Convertible Notes, which represents an initial conversion price of approximately $ 15.60 per share of common stock. The A&R Indenture reset the conversion rate to 132.1571 shares of common stock per $1,000 principal amount of 2028 Convertible Notes, which represents a conversion price of approximately $ 7.56675 per share of common stock. Noteholders that convert their 2028 Convertible Notes will be entitled to an additional premium payment representing the amount of certain of the remaining interest payments on the 2028 Convertible Notes as specified in the 2028 Convertible Notes Indenture. The conversion rate and conversion price will be subject to customary adjustments upon the occurrence of certain events. The 2028 Convertible Notes are redeemable, in whole and not in part, at the Company’s option at any time on or after December 19, 2024 , and in some circumstances prior to that date, at a cash redemption price equal to the principal amount of the 2028 Convertible Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date, but only if the last reported sale price per share of the Company’s common stock exceeds 150 % of the conversion price on (i) each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and including, the trading day immediately before the date the Company sends the related redemption notice; and (ii) the trading day immediately before the date the Company sends such notice. If certain corporate events that constitute a “Fundamental Change” (as defined in the A&R Indenture) occur, then noteholders may require the Company to repurchase their Notes at a cash repurchase price equal to the principal amount of the 2028 Convertible Notes to be repurchased, plus accrued and unpaid interest, if any, to, but excluding, the fundamental change repurchase date. The definition of Fundamental Change includes certain business combination transactions involving the Company, the failure to raise a specified amount of equity following completion of a strategic partnership as defined in the A&R Indenture and certain de-listing events with respect to the Company’s common stock, including delisting from the Nasdaq Global Market. The A&R Indenture contains covenants restricting the Company’s ability to incur indebtedness, incur liens, make restricted payments, make asset sales and engage in transactions with affiliates, subject to certain baskets. The A&R Indenture requires the Company to maintain minimum liquidity of $ 4.0 million and to add future assets to the collateral under the Security Agreement, dated as of December 19, 2023 , among the Company, the Guarantors party thereto and GLAS Trust Company LLC, as collateral agent (the "Security Agreement") and to add future subsidiaries as guarantors under the Security Agreement. The 2028 Convertible Notes have customary provision relating to the occurrence of “Events of Default” (as defined in the A&R Indenture). As of December 31, 2023 , the Company was in compliance with all such covenants. On July 31, 2024, the holders of the 2028 Convertible Notes agreed to extend the Forbearance Agreement until August 4, 2024. The parties subsequently agreed to extend the forbearance through October 31, 2024 . As of the date of this filing, the Company was in compliance with all such covenants. The 2028 Convertible Notes have several conversion features which are required to be bifurcated upon issuance and periodically remeasured to fair value separately as an embedded derivative. The conversion features were bifurcated and recorded separately as an embedded derivative remeasured at fair value each reporting period with changes in fair value recorded in other expense , net in the consolidated statement of operations.

Related Party Transactions

Related Party Transactions	9 Months Ended
	Sep. 30, 2024
Related Party Transactions [Abstract]
Related Party Transactions	7. Related Party Transactions In September 2023, entities affiliated with Athyrium Capital Management, LP ("Athyrium") exchanged an aggregate of $ 50.0 million principal amount of 2025 Convertible Notes for a combination of 923,528 shares of the Company's common stock, 739,921 pre-funded warrants and warrants to purchase up to 1,663,449 shares of common stock at an exercise price of $ 30.10 . As of December 31, 2023 , Athyrium held $ 17.4 million aggregate principal amount of 2028 Convertible Notes (see Note 6 ). Athyrium also held 1,092,976 shares, or 39.3 %, of the Company's common stock outstanding, 739,921 pre-funded warrants and warrants to purchase up to 2,458,320 shares of common stock at exercise prices ranging from of $ 30.10 to $ 82.20 . The Company's 2028 Convertible Notes June 1, 2024 interest payment was made in the form of PIK Notes. The payment was made to Athyrium by issuing additional 2028 Convertible Notes in an amount equal to the interest payment obligation of approximately $ 1.0 million. In August 2024, Athyrium entered into the Exchange Agreement pursuant to which the Company agreed to acquire an aggregate of $ 2.8 million of principal amount of the existing 2028 Convertible Notes in exchange for $ 2.8 million of Payment Priority Notes. In connection with the Exchange Agreement, the Company also agreed to amend an aggregate of 840,595 outstanding warrants held by Athyrium to (i) lower the exercise price to $ 6.00 per share, (ii) provide that the warrants were not exercisable until the Company receives stockholder approval and (iii) extend the original expiration date to be five years from stockholder approval. In September 2024 as part of the transactions contemplated by the Exchange Agreement, Athyrium exchanged an additional $ 2.8 million of the existing 2028 Convertible Notes in exchange for $ 2.8 million of Payment Priority Notes (see Note 6). As of September 30, 2024 , Athyrium held $ 18.4 million aggregate principal amount of 2028 Convertible Notes, including $ 1.0 million in PIK Notes (see Note 6 ). Athyrium also held 1,092,975 shares, or 29.7 %, of the Company's common stock outstanding, 739,921 pre-funded warrants and warrants to purchase up to 2,504,044 shares of common stock at exercise prices ranging from of $ 6.00 to $ 30.10 as of September 30, 2024. In June 2023, the Company entered into a securities purchase agreement with certain institutional and accredited investors relating to the offering and sale of 150,943 shares of common stock in a registered direct offering at an offering price of $ 53.00 per share. In addition, in a concurrent private placement, the Company issued unregistered warrants to purchase 301,886 shares of common stock (see Note 9 ) to the same investors. Following this transaction, the institutional and accredited investors became related parties due to greater than 5 % ownership. As of September 30, 2023, the institutional and accredited investors held less than 5 % of the Company's outstanding common stock and are no longer considered related parties. In November 2022, the Company entered into a securities purchase agreement with an institutional investor. Following this transaction, the institutional investor became a related party due to greater than 5 % ownership. On January 12, 2023, the Company issued warrants to purchase 9,000 shares of common stock to the institutional investor in exchange for the investor’s agreement to waive the lockup provisions contained in the November 2022 securities purchase agreement. As of March 31, 2023, this institutional investor held less than 5 % of the Company's outstanding common stock and is no longer considered a related party.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	8 . Commitments and Contingencies Operating Leases The Company has entered into various noncancelable operating lease agreements, primarily for office space, laboratory space, and equipment. In March 2023, the Company signed an amended lease agreement for certain office space in San Diego, California to decrease the office space and extend the term to June 2025. In August 2023, the Company signed a 36-month lease agreement for office space in Dallas, Texas. Cash paid for operating leases was $ 0.8 million and $ 0.9 million for the nine months ended September 30, 2024 and 2023, respectively. The components of lease expense were as follows (in thousands): Three Months Ended Nine Months Ended 2024 2023 2024 2023 Operating lease costs $ 235 $ 311 $ 706 $ 1,104 Supplemental weighted-average information related to operating leases was as follows: September 30, 2024 2023 Weighted-average remaining lease term (years) 1.6 2.3 Weighted-average discount rate 9.5 % 9.7 % As of September 30, 2024, future lease payments under the non-cancelable operating leases were as follows (in thousands): Year ending December 31, Minimum 2024 (remaining) $ 259 2025 590 2026 264 2027 18 2028 and thereafter — Total minimum lease payments 1,131 Less: interest ( 77 ) Present value of lease liabilities $ 1,054 Contingencies The Company, in the ordinary course of its business, can be involved in lawsuits, threats of litigation, and audit and investigative demands from third parties. While management is unable to predict the exact outcome of such matters, it is management’s current belief that any potential liabilities of Biora resulting from these contingencies, individually or in the aggregate, could have a material impact on the Company’s financial position and results of operations. The regulations governing government reimbursement programs (e.g., Medicaid, Tricare, and Medicare) and commercial payor reimbursement programs are complex and may be subject to interpretation. As a former provider of services to patients covered under government and commercial payor programs, post payment review audits, and other forms of reviews and investigations are routine. The Company believes it complied in all material respects with the statutes, regulations, and other requirements applicable to its former Laboratory Operations. Government Investigations Settlements In April 2018, the Company received a civil investigative demand from an Assistant U.S. Attorney (“AUSA”) for the Southern District of New York and a Health Insurance Portability and Accountability Act subpoena issued by an AUSA for the Southern District of California (“SDCA”) around legacy commercial practices. In May 2018, the Company received a subpoena from the State of New York Medicaid Fraud Control Unit. On July 21, 2020, July 23, 2020 and October 1, 2020, the Company entered into agreements (the "Agreements") with certain governmental agencies and the 45 states participating in the settlement (“State AGs”) to resolve, with respect to such agencies and State AGs, all of such agencies’ and State AGs’ outstanding civil, and, where applicable, federal criminal investigations described above. The Company paid $ 2.8 million and $ 1.7 million during the nine months ended September 30, 2024 and 2023, respectively. As of September 30, 2024, the Company’s accrual consisted of $ 2.6 million in accrued expenses and other current liabilities. The Company made a payment of $ 0.3 million in October 2024, and the remaining $ 2.3 million due on or before July 1, 2024, plus interest at a rate of 1.25 % per annum, was extended by the governmental agencies and State AGs and is now due on or before November 30, 2024. In connection with the resolution of the investigated matters, and in exchange for the Office of Inspector General of the Department of Health and Human Services ("OIG") agreement not to exercise its authority to permissively exclude the Company from participating in federal healthcare programs, effective July 21, 2020, the Company entered into a five-year Corporate Integrity Agreement with the OIG. The Corporate Integrity Agreement requires, among other matters, that the Company maintain a Compliance Officer, a Compliance Committee, board review and oversight of certain federal healthcare compliance matters, compliance programs, and disclosure programs; provide management certifications and compliance training and education; engage an independent review organization to conduct claims and arrangements reviews; and implement a risk assessment and internal review process. In view of the Company's cessation of its Laboratory Operations and related billing for services, effective March 7, 2023, the OIG agreed to suspend the Company’s obligations under the Corporate Integrity Agreement. Payor Recoveries As noted above, the regulations governing government reimbursement programs (e.g., Medicaid, Tricare, and Medicare) and commercial payor reimbursement programs are complex and may be subject to interpretation. As a former provider of services to patients covered under government reimbursement and commercial payor programs, the Company could be subject to post-payment review audits and other forms of reviews and investigations. If a third-party payor successfully challenges that a payment to the Company for prior testing was in breach of contract or otherwise contrary to policy or law, they may recoup such payment. The Company may also decide to negotiate and settle with a third-party payor in order to resolve an allegation of overpayment. In the past, the Company has negotiated and settled these types of claims with third-party payors. The Company may be required to resolve further disputes in the future. While management is unable to predict the exact outcome of any such claims, it is management’s current belief that any potential liabilities resulting from these contingencies related to payors and the Company's ceased Laboratory Operations, individually or in the aggregate, should not have a material impact on the Company’s financial position and results of operations. Ravgen Litigation On December 22, 2020, Ravgen, Inc. ("Ravgen") filed suit in the District of Delaware (D. Del. Civil Action No. 1:20-cv-1734) two Ravgen patents based on the Company's former NIPT testing business. The complaint sought monetary damages and injunctive relief. The Company responded to the complaint on March 23, 2021 rejecting Ravgen's assertions. On September 4, 2024, Ravgen and the Company settled the lawsuit without payment by either party and on September 9, 2024, the District Court dismissed the lawsuit with prejudice. IPO Litigation On June 23, 2020, the Company closed its IPO. Lawsuits were filed on August 28, 2020 and September 11, 2020 against the Company, certain of its executive officers and directors, and the underwriters of the IPO. On December 3, 2020, the U.S. District Court for the Southern District of California ("SDCA") consolidated the two actions, appointed Lin Shen, Lingjun Lin and Fusheng Lin to serve as Lead Plaintiffs, and approved Glancy Prongay & Murray LLP to be Lead Plaintiffs’ Counsel. Lead Plaintiffs filed their first amended complaint on February 4, 2021. Together with the underwriters of the IPO, the Company moved to dismiss the first amended complaint. On September 1, 2021, the court granted the Company's motion to dismiss, dismissing Lead Plaintiffs’ claims without prejudice. On September 22, 2021, Lead Plaintiffs filed their second amended complaint. Together with the underwriters of the IPO, the Company moved to dismiss the second amended complaint on November 15, 2021. On January 13, 2023, the court again granted our motion to dismiss, dismissing Lead Plaintiffs’ claims for failure to state a claim without prejudice. On February 3, 2023, Lead Plaintiffs filed their third amended complaint, adding information allegedly produced to Plaintiffs in response to freedom of information requests. The third amended complaint alleges that the Company’s registration statement and related prospectus for the IPO contained false and misleading statements and omissions in violation of the Securities Act by failing to disclose that (i) the Company had overbilled government payors for Preparent tests beginning in 2019 and ending in or before early 2020; (ii) there was a high probability that the Company had received, and would have to refund, a material amount of overpayments from government payors for Preparent tests; (iii) in February 2020 the Company ended a supposedly improper marketing practice on which the competitiveness of the Company's business depended; and (iv) the Company was suffering from material negative trends with respect to testing volumes, average selling prices for its tests, and revenues. Lead Plaintiffs seek certification as a class, unspecified compensatory damages, interest, costs and expenses including attorneys’ fees, and unspecified extraordinary, equitable, and/or injunctive relief. The Company filed a motion to dismiss the third amended complaint with prejudice on March 20, 2023, which the court granted on July 12, 2023. Lead Plaintiffs filed a notice of appeal on August 11, 2023 and the appeal is currently before the United States Court of Appeals for the Ninth Circuit (Case No: 23-55716) with appellate briefing concluded and submitted by the parties in March 2024. Subject to a reservation of rights, the Company is advancing expenses subject to indemnification to the underwriters of the IPO. In March 2024, the Company and Lead Plaintiffs agreed to settle the litigation, subject to negotiation and entry into definitive and binding agreements and court approval, for an amount of $ 1.0 million. This amount is included in accrued expense s and other current liabilities as of September 30, 2024. The Company and Lead Plaintiffs entered into a stipulation and agreement of settlement filed with the District Court on September 19, 2024 and on September 23, 2024, Lead Plaintiffs filed an unopposed motion with the District Court for preliminary approval of class action settlement. On June 4, 2021, a purported shareholder filed a lawsuit in the U.S. District Court for the SDCA, claiming to sue derivatively on behalf of the Company. The complaint names certain of the Company’s officers and directors as defendants, and names the Company as a nominal defendant. Premised largely on the same allegations as the above-described securities lawsuit, it alleges that the individual defendants breached their fiduciary duties to the Company, wasted corporate assets, and caused the Company to issue a misleading proxy statement in violation of the Securities Exchange Act of 1934, as amended. The complaint seeks the award of unspecified damages to the Company, equitable and injunctive remedies, and an order directing the Company to reform and improve its internal controls and board oversight. It also seeks the costs and disbursements associated with bringing suit, including attorneys’, consultants’, and experts’ fees. The case is stayed pending the resolution of the underlying matter in the above-described securities lawsuit. On August 17, 2021, the Company received a letter purportedly on behalf of a stockholder of the Company demanding that the Company's board of directors investigate and take action against certain of the Company’s current and former officers and directors to recover damages for alleged breaches of fiduciary duties and related claims arising out of the IPO litigation discussed above. This matter is pending the outcome of the underlying matter in the above-described securities lawsuit. Given the uncertainty of litigation and the legal standards that must be met for, among other things, success on the merits, the Company is unable to predict the ultimate outcome of these actions, and therefore cannot estimate the reasonably possible loss or range of loss, if any, that may result from these actions.

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2024
Stockholders' Equity Note [Abstract]
Stockholders' Equity	9 . Stockholders’ Equity Common Stock On January 3, 2023, the Company effected the 2023 Reverse Stock Split of the Company's common stock. The 2023 Reverse Stock Split, which has been retroactively reflected throughout the condensed consolidated financial statements, reduced the authorized shares of the Company to 164,000,000 and did not change the par value of the Company's common stock. On June 5, 2024, the Company’s stockholders approved an increase in the number of authorized shares of the Company's common stock from 164,000,000 to 300,000,000 and the Company filed a Certificate of Amendment to its Amended and Restated Certificate of Incorporation with the Secretary of State of the State of Delaware to effect such increase, which became effective immediately upon filing. On October 18, 2024, the Company effected the 2024 Reverse Stock Split of the Company's common stock. The 2024 Reverse Stock Split, which has been retroactively reflected throughout the condensed consolidated financial statements, did not change the par value of the Company's common stock. Also effective October 18, 2024, the Company filed a Certificate of Amendment to its Amended and Restated Certificate of Incorporation with the Secretary of State of the State of Delaware to effect a reduction in the number of authorized shares of the Company from 300,000,000 to 255,000,000 . Registered Offerings In January 2023, the Company issued warrants to purchase 9,000 shares of common stock to an institutional investor in exchange for the investor’s agreement to waive the lockup provisions contained in the securities purchase agreement related to the registered direct offering completed in November 2022. The warrants have an exercise price of $ 82.20 and were exercisable beginning on May 9, 2023 . In connection with the March 2024 Offering (as defined below), the warrants were amended to (i) lower the exercise price to $ 11.00 per share , (ii) provide that the warrants were not exercisable until the Stockholder Approval Date and (iii) extend the original expiration date to be five years from the Stockholder Approval Date. Pursuant to ASC 815, the Company deemed the warrants to be classified as a liability at fair value initially with subsequent changes in fair value recorded in earnings. In June 2023, the Company entered into a securities purchase agreement with certain institutional and accredited investors relating to the offering and sale of 150,943 shares of common stock in a registered direct offering at an offering price of $ 53.00 per share (the "June 2023 Offering"). In addition, in a concurrent private placement with the same investors, the Company issued unregistered warrants to purchase 301,886 shares of common stock. At issuance, the warrants had an exercise price of $ 50.50 per share and were exercisable at any time. The Company received approximately $ 7.3 million in net proceeds, after deducting placement agent fees and offering expenses. In connection with the March 2024 Offering (as defined below), the warrants were amended to (i) lower the exercise price to $ 11.00 per share , (ii) provide that the warrants were not exercisable until the Stockholder Approval Date and (iii) extend the original expiration date to be five years from the Stockholder Approval Date. Pursuant to ASC 815, the Company deemed the warrants to be classified as a liability at fair value initially with subsequent changes in fair value recorded in earnings. The warrants were recorded at a fair value of $ 9.0 million, as the total fair value of the warrant liability exceeds the gross proceeds of $ 8.0 million, the Company recorded a loss of the $ 1.0 million excess to gain (loss) on warrant liabilities in the consolidated statements of operations. Accordingly, there were no proceeds allocated to the common stock issued as part of this transaction. The Company incurred a total of $ 0.7 million in issuance costs, which were allocated between the warrants and common stock on a relative fair value basis. In October 2023, the Company issued warrants to purchase up to 100,000 shares and 427,807 shares of the Company's common stock, with exercise prices of $ 19.30 per share and $ 18.70 per share , respectively, to accredited investors in private placement transactions. The warrants are exercisable in April 2024 , six months following the dates of issuance. The investors may from time to time agree to acquire, and the Company may agree to sell, up to an aggregate of $ 9.9 million of common stock at any time prior to January 31, 2024. The warrants will vest in proportion to issuances described in the preceding sentence. Pursuant to ASC 815, the Company deemed the warrants to be classified as a liability at fair value initially with subsequent changes in fair value recorded in earnings. The warrants were recorded at a fair value of $ 6.7 million and the Company recorded a loss of the $ 6.7 million excess to gain (loss) on warrant liabilities in the consolidated statements of operations. On January 31, 2024, warrants to purchase 84,836 shares and 137,868 shares , respectively, of the Company's common stock vested and were reclassified to equity on the vesting termination date, the remaining warrants expired and the Company recognized a gain of $ 1.5 million included in gain on warrant liabilities on the consolidated statements of operations. On March 31, 2024, the Company entered into a securities purchase agreement with certain institutional and accredited investors relating to (1) the offering and sale of an aggregate of 545,454 shares of the Company’s common stock at an offering price of $ 11.00 per share in a registered direct offering and (2) the issuance of unregistered warrants to purchase up to 545,454 shares of the Company's common stock with an exercise price of $ 11.00 to certain accredited investors in a concurrent private placement (collectively, the "March 2024 Offering"). The March 2024 Offering closed and was recorded in April 2024 . The Company received net proceeds of $ 5.5 million after deducting placement agent fees and offering expenses. In connection with the March 2024 Offering, the Company also agreed to amend an aggregate of 641,582 outstanding warrants held by purchasers in the offering to (i) lower the exercise price to $ 11.00 per share , (ii) provide that the warrants were not exercisable until the Stockholder Approval Date and (iii) extend the original expiration date to be five years from the Stockholder Approval Date. Pursuant to ASC 815, the Company deemed the warrants to be classified as a liability at fair value initially with subsequent changes in fair value recorded in earnings. The Company incurred a total of $ 0.7 million in issuance costs, which were allocated between the warrants and common stock on a relative fair value basis. Common Stock Warrants As of September 30, 2024, the Company had the following warrants outstanding to acquire shares of its common stock: Expiration Date Shares of common stock issuable upon exercise of warrants Exercise price per share Held by Related Parties N/A 739,921 $ 0.01 September 2026 1,663,449 $ 30.10 August 2028 82,412 $ 6.00 March 2029 712,459 $ 6.00 October 2029 45,724 $ 6.00 Related Parties Total 3,243,965 Held by Non-affiliates February 2026 6,993 $ 1,715.00 August 2026 45,263 $ 250.00 April 2027 137,868 $ 18.70 April 2027 84,836 $ 19.30 March 2029 803,010 $ 6.00 June 2029 200,000 $ 6.00 June 2029 818,468 $ 11.00 September 2029 368,568 $ 6.00 October 2029 79,272 $ 6.00 November 2029 1,353,329 $ 6.00 Non-affiliate Total 3,897,607 Total 7,141,572 At-The-Market Sales Agreement and Offering and Equity Distribution Agreement In November 2021, the Company entered into an At Market Issuance Sales Agreement with B. Riley Securities, Inc., BTIG, LLC, and H.C. Wainwright & Co. LLC ("Agents"), pursuant to which the Company may offer and sell shares of common stock having an aggregate offering price of up to $ 90.0 million from time to time, in “at the market” offerings through the Agents (the "ATM Facility"). In connection with the registered direct offering in November 2022, the aggregate offering price was reduced to $ 70.0 million. The Company further reduced the aggregate offering price to $ 12.0 million in connection with the June 2023 Offering. A s of October 9, 2023, the aggregate offering price was increased to $ 37.6 million. Sales of the shares of common stock, if any, will be made at prevailing market prices at the time of sale, or as otherwise agreed with the Agents. The Agents will receive a commission from the Company of up to 3.0 % of the gross proceeds of any shares of common stock sold under the ATM Facility. On July 1, 2024, the Company entered into an Equity Distribution Agreement (the "Sale Agreement") with Canaccord Genuity LLC and H.C. Wainwright & Co., LLC (the "Agents"), pursuant to which the Company may offer and sell from time to time up to $ 90.0 million in shares of common stock in "at the market offerings" through the Agents. Due to the offering limitations applicable to the Company under General Instruction I.B.6. of Form S-3 and its public float as of July 1, 2024, and in accordance with the terms of the Sale Agreement, the Company may sell shares of its common stock having an aggregate gross sales price of up to $ 6.0 million. If its public float increases such that the Company may sell additional amounts under the Sale Agreement and its registration statement on Form S-3, the Company will file another prospectus supplement prior to making additional sales. The Company has no obligation to sell any shares under the Sale Agreement, and may suspend offers or terminate the Sale Agreement at any time. Sales of the shares of common stock, if any, will be made at prevailing market prices at the time of sale, or as otherwise agreed with the Agents. The Agents will receive a commission from the Company of up to 3.0 % of the gross proceeds of any shares of common stock sold pursuant to the Sale Agreement. The following table provides information on the shares sold under the ATM Facility and Sale Agreement for the three and nine months ended September 30, 2024 and 2023. Three Months Ended Nine Months Ended 2024 2023 2024 2023 Net proceeds (in millions) $ 0.4 $ 0.2 $ 3.2 $ 12.7 Number of shares 52,581 8,292 311,739 293,603 Weighted average purchase price $ 6.90 $ 21.86 $ 10.86 $ 45.45 Preferred Stock Pursuant to the Company’s eighth amended and restated certificate of incorporation, which went into effect immediately prior to the completion of the IPO, the Company was authorized to issue 10,000,000 shares of undesignated preferred stock. This amount and the par value of preferred stock remained unchanged after the 2023 Reverse Stock Split. On November 10, 2022, the Board declared a dividend of one one-thousandth of a share of Series X Preferred Stock, par value $ 0.001 per share (“Series X Preferred Stock”), for each outstanding share of common stock to stockholders of record as of November 21, 2022. This Series X Preferred Stock entitled its holders to 3,000 votes per share exclusively on the vote for the proposal to approve the 2023 Reverse Stock Split. All shares of Series X Preferred Stock that were not present to vote on the 2023 Reverse Stock Split were redeemed by the Company (the “Initial Redemption”). Any outstanding shares of Series X Preferred Stock that were not redeemed pursuant to an Initial Redemption would be redeemed in whole, but not in part, (i) if such redemption is ordered by the Board in its sole discretion, automatically and effective on such time and date specified by the Board in its sole discretion or (ii) automatically upon the effectiveness of the Certificate of Amendment implementing the 2023 Reverse Stock Split. At the December 19, 2022 special meeting of the Company's stockholders, the holders of 136,961 shares of Series X Preferred Stock were represented in person or by proxy. Immediately prior to the special meeting, all 86,210 shares of Series X Preferred Stock that were not voted were redeemed. The remaining 136,961 outstanding shares of Series X Preferred Stock were redeemed automatically upon the effectiveness of the Certificate of Amendment on January 3, 2023. On January 9, 2023, the Company filed a Certificate of Elimination of Series X Preferred Stock with the Delaware Secretary of State, which, effective immediately upon filing, eliminated all matters set forth in the Certificate of Designation of Series X Preferred Stock filed with the Delaware Secretary of State on November 21, 2022.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2024
Share-Based Payment Arrangement [Abstract]
Stock-Based Compensation	10 . Stock-Based Compensation In February 2018, the Company adopted the 2018 Equity Incentive Plan (“2018 Plan”). The 2018 Plan is the successor to and continuation of the Second Amended and Restated 2012 Stock Plan (“2012 Plan”) and is administered with either stock options or RSUs. The Board administers the plans. Upon adoption of the 2018 Plan, no new stock options or awards are issuable under the 2012 Plan, as amended. The 2018 Plan also provides for other types of equity to issue awards, which at this time the Company does not plan to utilize. On June 14, 2023, the Company’s stockholders approved the Fifth Amended and Restated 2018 Equity Incentive Plan ("2018 Fifth Amended Plan"), which included an increase of 550,000 shares of common stock reserved for issuance. As of September 30, 2024 there were 511,562 shares available for issuance under the 2018 Fifth Amended Plan. In November 2024, the Company’s stockholders approved an amendment and restatement of the Company’s 2018 Fifth Amended Plan to increase the number of shares authorized for issuance by 1,850,000 shares and to extend the term of the Plan to October 10, 2034 . On November 3, 2021, the Board approved and adopted the Company’s 2021 Inducement Plan ("2021 Inducement Plan") to provide for the reservation of 26,000 shares of the Company’s common stock to be used exclusively for the grant of awards to individuals not previously an employee or non-employee director of the Company. As of September 30, 2024, 6,779 shares were available for grant under the 2021 Inducement Plan. Stock Options The following table summarizes stock option activity, which includes performance awards, under the 2012 Plan, the 2018 Fifth Amended Plan and the 2021 Inducement Plan during the nine months ended September 30, 2024: Stock Options Weighted- Weighted- Aggregate Balance at December 31, 2023 76,301 $ 362.33 Options granted 10,880 $ 6.52 Options exercised — $ — Options forfeited/cancelled ( 3,795 ) $ 248.08 Balance at September 30, 2024 83,386 $ 321.11 7.9 $ — Vested and expected to vest at September 30, 2024 83,386 $ 321.11 7.9 $ — Vested and exercisable at September 30, 2024 44,243 $ 480.71 7.2 $ — The Company uses the Black-Scholes option pricing model to estimate the fair value of each option grant on the date of grant or any other measurement date. The following table sets forth the assumptions used to determine the fair value of stock options granted during the nine months ended September 30, 2024 and 2023: Nine Months Ended 2024 2023 Risk-free interest rate 3.6 % - 4.7 % 3.5 % - 4.4 % Expected volatility 92.8 % - 96.8 % 98.5 % - 102.7 % Expected dividend yield ― ― Expected life (years) 5.5 - 6.3 5.5 - 6.3 The weighted-average grant date fair value of options granted during the nine months ended September 30, 2024 and 2023 was $ 5.50 per option and $ 28.76 per option, respectively. Restricted Stock Units The following table summarizes RSU activity for the nine months ended September 30, 2024: Number of Shares Weighted- Balance at December 31, 2023 253,735 $ 33.07 Granted 281,300 $ 8.02 Vested ( 63,354 ) $ 33.54 Forfeited/cancelled ( 19,865 ) $ 38.43 Balance at September 30, 2024 451,816 $ 17.17 In August 2023, the Board approved the acceleration of vesting of all unvested, outstanding RSUs. As a result of this modification, an additional $ 7.9 million of stock-based compensation expense was recognized during the three months ended September 30, 2023. Stock-Based Compensation Expense The following table presents total stock-based compensation expense included in each functional line item in the accompanying condensed consolidated statements of operations (in thousands): Three Months Ended Nine Months Ended 2024 2023 2024 2023 Research and development 682 4,680 1,970 6,308 Selling, general and administrative 599 5,851 2,423 8,621 Total stock-based compensation expense $ 1,281 $ 10,531 $ 4,393 $ 14,929 At September 30, 2024 there was $ 3.8 million of compensation cost related to unvested stock options expected to be recognized over a remaining weighted average vesting period of 2.2 years and $ 7.1 million of compensation cost related to unvested RSUs expected to be recognized over a remaining weighted average vesting period of 3.2 years.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2024
Income Tax Disclosure [Abstract]
Income Taxes	11 . Income Taxes The Company calculates its interim income tax provision in accordance with ASC Topic 270, Interim Reporting , and ASC Topic 740, Accounting for Income Taxes . At the end of each interim period, management estimates the annual effective t ax rate and applies such rate to the Company’s ordinary quarterly earnings to calculate income tax expense related to ordinary income. The Company's effective tax rate was zero for the three and nine months ended September 30, 2024 and 2023. The tax effects of items significant, unusual and infrequent in nature are discretely calculated and recognized in the period during which they occur. The Company’s net operating loss carryforwards and research and development expenditure credit carryforwards may be subject to an annual limitation under Sections 382 and 383 of the Internal Revenue Code of 1986, as amended (the “Code”), and similar state provisions if the Company experiences an ownership change within the meaning of such Code sections. In general, an ownership change, as defined by Sections 382 and 383 of the Code, occurs when there is a 50 percentage points or more shift in ownership, consisting of shareholders owning more than 5 % in the Company, occurr ing within a three-year testing period. The Company performed a formal study through the date of the IPO and determined future utilization of tax attribute carryforwards were not limited per Section 382 of the Internal Revenue Code. The Company has not updated its Section 382 study since the IPO offering in 2020. However, because the Company has raised and expects to continue to raise significant amounts of equity, the Company expects that Section 382 will limit future utilization of tax attribute carryforwards. Due to the existence of the valuation allowance, limitations created by future ownership changes, if any, will not impact the Company's effective tax rate.

Net Loss Per Share

Net Loss Per Share	9 Months Ended
	Sep. 30, 2024
Earnings Per Share [Abstract]
Net Loss Per Share	12. Net Loss Per Share The table below provides potentially dilutive securities in equivalent shares of common stock not included in the Company’s calculation of diluted loss per share because to do so would be antidilutive: September 30, September 30, Stock options to purchase common stock 83,386 73,249 Restricted stock units 451,816 256,451 Common stock warrants and pre-funded warrants 7,141,572 2,947,419 Common stock issuable upon conversion of Convertible Notes 7,710,442 101,129 Total 15,387,216 3,378,248

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2024
Subsequent Events [Abstract]
Subsequent Events	13. Subsequent Events From October 1, 2024 through October 18, 2024, the Company received net proceeds of $ 0.5 million , after deducting commissions and other offering expenses, from the sale of 99,672 shares under the Sale Agreement. The Company sold such shares at a weighted average purchase price of $ 4.67 per share. On October 7, 2024 as part of the Debt Exchange Transactions (see Note 6 ), the Holders purchased an additional $ 4.0 million aggregate principal amount of Payment Priority Notes and were granted warrants to purchase an aggregate of 676,666 shares of common stock with an exercise price of $ 6.00 per share. Additionally, the Company acquired an aggregate of $ 10.8 million principal amount, plus accrued and unpaid interest thereon, of the existing 2028 Notes in exchange for $ 10.8 million Payment Priority Notes. On October 28, 2024, the Company entered into a securities purchase agreement with certain institutional and accredited investors relating to (1) the offering and sale of an aggregate of 745,342 shares of the Company's common stock at an offering price of $ 4.025 per share in a registered direct offering and (2) the issuance of unregistered warrants to purchase up to 745,342 shares of the Company's common stock with an exercise price of $ 3.90 to certain accredited investors in a concurrent private placement (collectively, the "October 2024 Offering"). The Company received gross proceeds from the Offering of approximately $ 3.0 million before deducting placement agent fees and estimated offering expenses. In connection with the October 2024 Offering, the Company also agreed to amend an aggregate of 531,162 outstanding warrants held by purchasers in the offering to (i) lower the exercise price to $ 3.90 per share and (ii) extend the original expiration date to October 29, 2029.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The Company’s condensed consolidated financial statements have been prepared in conformity with accounting principles generally accepted in the United States of America (“GAAP”) for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. These financial statements should be read in conjunction with the Company’s audited consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023, as filed with the Securities and Exchange Commission, from which management derived the Company’s condensed consolidated balance sheet as of December 31, 2023. The condensed consolidated financial statements and notes thereto give retrospective effect to the 2023 Reverse Stock Split and the 2024 Reverse Stock Split for all periods presented. All common stock, options exercisable for common stock, restricted stock units ("RSUs"), warrants and per share amounts contained in the condensed consolidated financial statements have been retrospectively adjusted to reflect the 2023 Reverse Stock Split and the 2024 Reverse Stock Split for all periods presented.
Unaudited Interim Financial Information	Unaudited Interim Financial Information The accompanying condensed consolidated financial statements are unaudited, have been prepared on the same basis as the audited annual financial statements and, in the opinion of management, reflect all adjustments, consisting of normal recurring adjustments, that are necessary to present fairly the results for the interim periods presented. Results are not necessarily indicative of results to be expected for the year ending December 31, 2024, any other interim periods, or any future year or period. The balance sheet as of December 31, 2023 included herein was derived from the audited financial statements as of that date. Certain disclosures have been condensed or omitted from the interim financial statements.
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities as of the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Significant items subject to such estimates include the valuation of stock options, the valuation of goodwill, the valuation of the derivative liabilities associated with the 2028 Convertible Notes, accrual for reimbursement claims and settlements, the valuation of warrant liabilities, assessing future tax exposure and the realization of deferred tax assets, and the useful lives and the recoverability of property and equipment. The Company bases these estimates on historical and anticipated results, trends, and various other assumptions that the Company believes are reasonable under the circumstances, including assumptions as to future events. These estimates form the basis for making judgments about the carrying values of assets and liabilities and recorded revenues and expenses that are not readily apparent from other sources. Actual results could differ from those estimates and assumptions.
Restricted Cash	Restricted Cash Restricted cash consists of collateral required for the Company's bank-issued credit cards with a balance of $ 0.2 million as of both September 30, 2024 and December 31, 2023 .
Recent Accounting Pronouncements Adopted	Recent Accounting Pronouncements Adopted In August 2020, the Financial Accounting Standards ("FASB") issued Accounting Standards Update ("ASU") No. 2020-06 , Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging-Contracts in Entity's Own Equity (Subtopic 815-40)—Accounting for Convertible Instruments and Contracts in an Entity's Own Equity , which simplifies the accounting for convertible instruments, amends the guidance on derivative scope exceptions for contracts in an entity's own equity, and modifies the guidance on diluted earnings per share calculations as a result of these changes. The standard is effective for the Company for annual reporting periods beginning after December 15, 2023. The Company adopted this standard on January 1, 2024, and it did not have a material impact on the consolidated financial statements.
Recent Accounting Pronouncements Not Yet Adopted	Recent Accounting Pronouncements Not Yet Adopted In December 2023, the FASB issued ASU No. 2023-09, Improvements to Income Tax Disclosures , which introduces new and enhanced income tax disclosure requirements. The standard is effective for the Company for annual reporting periods beginning after December 15, 2024. The Company is currently evaluating the impact the adoption of this standard may have on its consolidated financial statements and related disclosures.

Strategic Transformation (Table

Strategic Transformation (Tables)	9 Months Ended
	Sep. 30, 2024
Discontinued Operations and Disposal Groups [Abstract]
Summary of Results of Discontinued Operations and Class of Assets and Liabilities	The following table presents the combined results of discontinued operations of the Laboratory Operations for the three and nine months ended September 30, 2024 (in thousands); there was no gain or loss from discontinued operations for the three and nine months ended September 30, 2023: Three Months Ended Nine Months Ended September 30, 2024 Revenues $ — $ — Operating expenses: Selling, general and administrative (1) ( 3,816 ) ( 3,816 ) Total operating expenses ( 3,816 ) ( 3,816 ) Net gain from discontinued operations $ 3,816 $ 3,816 (1) Related to the reversal of amounts that were expensed in discontinued operations in 2021 and settled for a lower amount during the three months ended September 30, 2024.

Balance Sheet Components (Table

Balance Sheet Components (Tables)	9 Months Ended
	Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Summary of Prepaid Expenses and Other Current Assets	Prepaid expenses and other current assets consisted of the following (in thousands): September 30, December 31, Prepaid expenses $ 1,945 $ 2,443 Other current assets 45 587 Total $ 1,990 $ 3,030
Summary of Property and Equipment, Net	Property and equipment, net consisted of the following (in thousands): September 30, December 31, Computers and software $ 1,210 $ 1,193 Building and leasehold improvements 852 803 Laboratory equipment 714 423 Furniture, fixtures, and office equipment 799 799 Construction in progress 5 45 Total property and equipment 3,580 3,263 Less accumulated depreciation and amortization ( 2,405 ) ( 2,107 ) Property and equipment, net $ 1,175 $ 1,156
Schedule of Other Assets	Other assets consisted of the following (in thousands): September 30, December 31, Investment in Enumera $ — $ 3,000 Other 193 302 Total $ 193 $ 3,302
Summary of Accrued Expenses and Other Current Liabilities	Accrued expenses and other current liabilities consisted of the following (in thousands): September 30, December 31, Accrual for reimbursement claims and legal settlements, current (1) $ 3,572 $ 6,337 Accrued legal fees (2) 9,397 1,577 Commissions and bonuses 3,423 2,469 Vacation and payroll benefits 1,437 1,367 Accrued professional services 576 1,337 Accrued interest 1,439 173 Lease liabilities, current 717 896 Insurance financing 751 401 Contract liabilities — 542 Other (3) 92 2,220 Total $ 21,404 $ 17,319 (1) Laboratory Operations have been discontinued; amounts related to revenue reserves generated from the Laboratory Operations remain on the balance sheet. (2) The Company entered into an alternative fee arrangement with a professional services firm related to certain litigation matters; amounts related to the arrangement are included in accrued legal fees. (3) Included in the December 31, 2023 amount are contracts that the Company was responsible for that were expensed in discontinued operations in 2021.
Summary of Other Long-term Liabilities	Other long-term liabilities consisted of the following (in thousands): September 30, December 31, Lease liabilities, net of current portion 337 818 Other (1) 179 2,211 Total $ 516 $ 3,029 (1) Included in the December 31, 2023 amount are contracts that the Company was responsible for that were expensed in discontinued operations in 2021.

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2024
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis	The following table presents information about the Company’s assets and liabilities that are measured at fair value on a recurring basis and indicates the fair value hierarchy of the valuation techniques utilized to determine such fair value (in thousands): Level 1 Level 2 Level 3 September 30, 2024 Derivative liabilities $ — $ — $ 35,018 Warrant liabilities $ — $ — $ 18,688 December 31, 2023 Derivative liabilities $ — $ — $ 22,899 Warrant liabilities $ — $ — $ 40,834
Summary of Inputs and Assumptions used to Determine Fair Value of Warrant Liability	At September 30, 2024 and December 31, 2023, the fair value of the warrant liabilities were estimated using the Black-Scholes Model with the following inputs and assumptions: September 30, December 31, Risk-free interest rate 3.6 % - 3.7 % 3.8 % - 4.1 % Expected volatility 76.3 % - 94.7 % 95.6 % - 101.8 % Stock price $ 5.00 $ 13.50 Expected life (years) 1.9 - 5.0 2.5 - 5.0
Summary of Changes in Warrant Liabilities	A summary of the changes in the Level 3 classified liabilities is presented below (in thousands): Warrant Liabilities Derivative Liabilities Balance at December 31, 2023 $ 40,834 $ 22,899 Recognition of warrant liabilities 11,405 — Reclassification of warrant liabilities to equity ( 1,062 ) — Reclassification to warrant liabilities from equity 45 — Expired warrants ( 1,460 ) — Warrant reprice adjustment 4,938 — Extinguishment of derivative liabilities — ( 37,040 ) Recognition of derivative liabilities — 57,828 Change in fair value ( 36,012 ) ( 8,669 ) Balance at September 30, 2024 $ 18,688 $ 35,018
Monte Carlo Simulation [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Summary of Inputs and Assumptions used to Determine Fair Value of Warrant Liability	At September 30, 2024, the fair value of the warrant liabilities were estimated using the Monte Carlo simulation with the following inputs and assumptions: September 30, Risk-free interest rate 3.6 % Expected volatility 93.5 % - 94.2 % Stock price $ 5.00 Expected life (years) 3.9 - 5.0
Derivative Financial Instruments Liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Summary of Inputs and Assumptions used to Determine Fair Value of Warrant Liability	The fair value of the embedded derivatives as of September 30, 2024 and December 31, 2023 were estimated using a binomial pricing model with the following inputs and assumptions: September 30, December 31, Risk-free interest rate 3.5 % 3.8 % - 4.3 % Expected volatility 91.9 % 84.3 % - 95.7 % Stock price $ 5.00 $ 13.50 Discount rate 40.7 % 28.7 % - 28.9 %

Convertible Notes (Tables)

Convertible Notes (Tables)	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Summary of Significant Terms of Company's Convertible Notes	The following table summarizes significant terms of the Company's Convertible Notes at September 30, 2024 (in thousands): September 30, 2024 Face Value Carrying Value Fair Value (1) Stated Interest Rate Effective Interest Rate Non-Affiliate 2028 Convertible Notes (2) $ 39,901 $ 14,344 $ 14,807 11 - 13 % 50.9 % Related Party 2028 Convertible Notes (3) $ 18,400 $ 19,721 $ 5,853 11 - 13 % 24.7 % 2025 Convertible Notes $ 4,600 $ 4,527 $ 2,676 7.25 % 8.7 % (1) To estimate the fair value of the Non-Affiliate 2028 Convertible Notes, the Company used a binomial pricing model. Including the derivative liabilities of $ 23.0 million, the Non-Affiliate 2028 Convertible Notes fair value using the with method is $ 37.8 million. To estimate the fair value of the Related Party 2028 Convertible Notes, the Company used a binomial pricing model. Including the derivative liabilities of $ 12.1 million, the Non-Affiliate 2028 Convertible Notes fair value using the with method is $ 17.9 million. To estimate the fair value of the 2025 Convertible Notes, the Company used unadjusted quoted prices in the active market obtained from third-party pricing services. (2) The face value includes $ 24.0 million in Payment Priority Notes (as defined below) and $ 1.8 million in PIK Notes (as defined below). (3) The face value includes $ 5.5 million in Payment Priority Notes (as defined below) and $ 1.0 million in PIK Notes (as defined below). The following table summarizes significant terms of the Company’s Convertible Notes at December 31, 2023 (in thousands): December 31, 2023 Face Value Carrying Value Fair Value (4) Stated Interest Rate Effective Interest Rate Non-Affiliate 2028 Convertible Notes $ 23,500 $ 14,591 $ 14,846 11 - 13 % 48.9 % Related Party 2028 Convertible Notes $ 17,383 $ 21,155 $ 10,982 11 - 13 % ( 22.0 )% 2025 Convertible Notes $ 10,225 $ 9,966 $ 5,984 7.25 % 8.7 % (4) To estimate the fair value of the 2028 Convertible Notes, the Company used a binomial pricing model. Including the derivative liabilities of $ 22.9 million, the 2028 Convertible Notes fair value using the with method is $ 48.7 million. To estimate the fair value of the 2025 Convertible Notes, the Company used unadjusted quoted prices in the active market obtained from third-party pricing services.

Commitments and Contingencies (

Commitments and Contingencies (Tables)	9 Months Ended
	Sep. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
Components of Lease Expense	The components of lease expense were as follows (in thousands): Three Months Ended Nine Months Ended 2024 2023 2024 2023 Operating lease costs $ 235 $ 311 $ 706 $ 1,104
Supplemental Weighted-Average Information Related to Operating Leases	Supplemental weighted-average information related to operating leases was as follows: September 30, 2024 2023 Weighted-average remaining lease term (years) 1.6 2.3 Weighted-average discount rate 9.5 % 9.7 %
Schedule of Net Minimum Payments Under Non-Cancelable Operating Leases	As of September 30, 2024, future lease payments under the non-cancelable operating leases were as follows (in thousands): Year ending December 31, Minimum 2024 (remaining) $ 259 2025 590 2026 264 2027 18 2028 and thereafter — Total minimum lease payments 1,131 Less: interest ( 77 ) Present value of lease liabilities $ 1,054

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	9 Months Ended
	Sep. 30, 2024
Stockholders' Equity Note [Abstract]
Schedule of Warrants Outstanding to Acquire Shares of its Common Stock	As of September 30, 2024, the Company had the following warrants outstanding to acquire shares of its common stock: Expiration Date Shares of common stock issuable upon exercise of warrants Exercise price per share Held by Related Parties N/A 739,921 $ 0.01 September 2026 1,663,449 $ 30.10 August 2028 82,412 $ 6.00 March 2029 712,459 $ 6.00 October 2029 45,724 $ 6.00 Related Parties Total 3,243,965 Held by Non-affiliates February 2026 6,993 $ 1,715.00 August 2026 45,263 $ 250.00 April 2027 137,868 $ 18.70 April 2027 84,836 $ 19.30 March 2029 803,010 $ 6.00 June 2029 200,000 $ 6.00 June 2029 818,468 $ 11.00 September 2029 368,568 $ 6.00 October 2029 79,272 $ 6.00 November 2029 1,353,329 $ 6.00 Non-affiliate Total 3,897,607 Total 7,141,572
Schedule of Shares Sold Under the ATM Sale Agreement	The following table provides information on the shares sold under the ATM Facility and Sale Agreement for the three and nine months ended September 30, 2024 and 2023. Three Months Ended Nine Months Ended 2024 2023 2024 2023 Net proceeds (in millions) $ 0.4 $ 0.2 $ 3.2 $ 12.7 Number of shares 52,581 8,292 311,739 293,603 Weighted average purchase price $ 6.90 $ 21.86 $ 10.86 $ 45.45

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2024
Share-Based Payment Arrangement [Abstract]
Summary of Stock Options Activity under Plans	The following table summarizes stock option activity, which includes performance awards, under the 2012 Plan, the 2018 Fifth Amended Plan and the 2021 Inducement Plan during the nine months ended September 30, 2024: Stock Options Weighted- Weighted- Aggregate Balance at December 31, 2023 76,301 $ 362.33 Options granted 10,880 $ 6.52 Options exercised — $ — Options forfeited/cancelled ( 3,795 ) $ 248.08 Balance at September 30, 2024 83,386 $ 321.11 7.9 $ — Vested and expected to vest at September 30, 2024 83,386 $ 321.11 7.9 $ — Vested and exercisable at September 30, 2024 44,243 $ 480.71 7.2 $ —
Summary of Assumptions used to Determine Fair Value of Stock Options Granted	The following table sets forth the assumptions used to determine the fair value of stock options granted during the nine months ended September 30, 2024 and 2023: Nine Months Ended 2024 2023 Risk-free interest rate 3.6 % - 4.7 % 3.5 % - 4.4 % Expected volatility 92.8 % - 96.8 % 98.5 % - 102.7 % Expected dividend yield ― ― Expected life (years) 5.5 - 6.3 5.5 - 6.3
Summary of Restricted Stock Units Activity	The following table summarizes RSU activity for the nine months ended September 30, 2024: Number of Shares Weighted- Balance at December 31, 2023 253,735 $ 33.07 Granted 281,300 $ 8.02 Vested ( 63,354 ) $ 33.54 Forfeited/cancelled ( 19,865 ) $ 38.43 Balance at September 30, 2024 451,816 $ 17.17
Schedule of Stock-based Compensation Expense	The following table presents total stock-based compensation expense included in each functional line item in the accompanying condensed consolidated statements of operations (in thousands): Three Months Ended Nine Months Ended 2024 2023 2024 2023 Research and development 682 4,680 1,970 6,308 Selling, general and administrative 599 5,851 2,423 8,621 Total stock-based compensation expense $ 1,281 $ 10,531 $ 4,393 $ 14,929

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	9 Months Ended
	Sep. 30, 2024
Earnings Per Share [Abstract]
Summary of Potentially Dilutive Securities Not Included in Calculation of Diluted Loss Per Share	The table below provides potentially dilutive securities in equivalent shares of common stock not included in the Company’s calculation of diluted loss per share because to do so would be antidilutive: September 30, September 30, Stock options to purchase common stock 83,386 73,249 Restricted stock units 451,816 256,451 Common stock warrants and pre-funded warrants 7,141,572 2,947,419 Common stock issuable upon conversion of Convertible Notes 7,710,442 101,129 Total 15,387,216 3,378,248

Organization and Description _2

Organization and Description of Business - Additional Information (Details) - USD ($) $ in Thousands			3 Months Ended						9 Months Ended
	Oct. 18, 2024	Jan. 03, 2023	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2024	Sep. 30, 2023	Mar. 08, 2024	Dec. 31, 2023	Dec. 31, 2020
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items]
Reverse stock split description	1-for-10 reverse split	On January 3, 2023, the Company effected the 2023 Reverse Stock Split of the Company's common stock.
Cash and cash equivalents			$ 3,000						$ 3,000
Restricted cash			200						200
Accumulated deficit			967,084						967,084			$ 950,958
Net income			(18,402)	$ 6,465	$ (4,189)	$ (73,454)	$ (17,807)	$ (17,441)	(16,126)	$ (108,702)
Cash used in operating activities									32,178	$ 34,754
2028 Convertible Notes and Related Party 2028 Convertible Notes
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items]
Face Value			$ 58,300						$ 58,300
2028 Convertible Notes and Related Party 2028 Convertible Notes | Minimum
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items]
Interest rate			11%						11%
2028 Convertible Notes and Related Party 2028 Convertible Notes | Maximum
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items]
Interest rate			13%						13%
7.25% Convertible Senior Notes due 2025
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items]
Face Value			$ 4,600						$ 4,600		$ 5,600	$ 10,225	$ 168,500
Interest rate			7.25%						7.25%			7.25%	7.25%

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Additional Information (Details) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Summary Of Significant Accounting Policies [Line Items]
Restricted cash collateral for credit cards	$ 0.2	$ 0.2
Accounting Standards Update 2023-09 [Member]
Summary Of Significant Accounting Policies [Line Items]
Change in accounting principle, accounting standards update, adopted [true false]		false

Strategic Transformation - Addi

Strategic Transformation - Additional Information (Details) - USD ($)		3 Months Ended			9 Months Ended		12 Months Ended
	Oct. 06, 2023	Sep. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023	May 31, 2022
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain or loss from discontinued operations		$ 3,816,000		$ 0	$ 3,816,000	$ 0
Proceeds from sale of building held for sale	$ 2,800,000
Expense incurred in sale of building	$ 200,000
Proceeds from sale of equity securities					3,000,000	$ 0
Building
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Remaining assets of disposal group held for sale		$ 0			$ 0		$ 0
Enumera Molecular Inc
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment loss on investment							$ 3,000,000
Enumera Molecular Inc | Series A-1 Preferred Stock
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Minority ownership shares, issued								6,000,000
Minority ownership received in preferred stock								$ 6,000,000
Proceeds from sale of equity securities			$ 3,000,000
Preeclampsia Agreement
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Other income				1,500,000
Enumera Molecular, Inc
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Payments to related party				$ 400,000
Enumera Molecular, Inc | Series A-1 Preferred Stock
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Minority ownership stake, percentage								25%

Strategic Transformation - Summ

Strategic Transformation - Summary of Results of Discontinued Operations (Details) - USD ($)		3 Months Ended		9 Months Ended
		Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Discontinued Operations and Disposal Groups [Abstract]
Revenue		$ 0		$ 0
Selling, general and administrative	[1]	(3,816,000)		(3,816,000)
Total operating expenses		(3,816,000)		(3,816,000)
Net gain from discontinued operations		$ 3,816,000	$ 0	$ 3,816,000	$ 0
[1] (1) Related to the reversal of amounts that were expensed in discontinued operations in 2021 and settled for a lower amount during the three months ended September 30, 2024.

Balance Sheet Components - Summ

Balance Sheet Components - Summary of Prepaid Expenses and Other Current Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Prepaid expenses	$ 1,945	$ 2,443
Other current assets	45	587
Total	$ 1,990	$ 3,030

Balance Sheet Components - Su_2

Balance Sheet Components - Summary of Property and Equipment, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 3,580	$ 3,263
Less accumulated depreciation and amortization	(2,405)	(2,107)
Property and equipment, net	1,175	1,156
Computers and Software
Property, Plant and Equipment [Line Items]
Total property and equipment	1,210	1,193
Building and Leasehold Improvements
Property, Plant and Equipment [Line Items]
Total property and equipment	852	803
Laboratory Equipment
Property, Plant and Equipment [Line Items]
Total property and equipment	714	423
Furniture, Fixtures, and Office Equipment
Property, Plant and Equipment [Line Items]
Total property and equipment	799	799
Construction in Progress
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 5	$ 45

Balance Sheet Components - Sche

Balance Sheet Components - Schedule of Other Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Other	$ 193	$ 302
Total	193	3,302
Enumera Molecular Inc
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Investment in Enumera	$ 0	$ 3,000

Balance Sheet Components - Addi

Balance Sheet Components - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Depreciation expense	$ 0.1	$ 0.1	$ 0.3	$ 0.4

Balance Sheet Components - Su_3

Balance Sheet Components - Summary of Accrued Expenses and Other Current Liabilities (Details) - USD ($) $ in Thousands		Sep. 30, 2024	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Accrual for reimbursement claims and legal settlements, current	[1]	$ 3,572	$ 6,337
Accrued legal fees	[2]	9,397	1,577
Commissions and bonuses		3,423	2,469
Vacation and payroll benefits		1,437	1,367
Accrued professional services	[2]	576	1,337
Accrued interest		1,439	173
Lease liabilities, current		717	896
Insurance financing		751	401
Contract liabilities		0	542
Other	[3]	92	2,220
Total		$ 21,404	$ 17,319
[1] Laboratory Operations have been discontinued; amounts related to revenue reserves generated from the Laboratory Operations The Company entered into an alternative fee arrangement with a professional services firm related to certain litigation matters; amounts related to the arrangement are included in accrued legal fees. Included in the December 31, 2023 amount are contracts that the Company was responsible for that were expensed in discontinued operations in 2021.

Balance Sheet Components - Su_4

Balance Sheet Components - Summary of Other Long-term Liabilities (Details) - USD ($) $ in Thousands		Sep. 30, 2024	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Lease liabilities, net of current portion		$ 337	$ 818
Other	[1]	179	2,211
Total		$ 516	$ 3,029
[1] Included in the December 31, 2023 amount are contracts that the Company was responsible for that were expensed in discontinued operations in 2021.

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Details) - USD ($)	Sep. 30, 2024	Sep. 30, 2023
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Fair Value Assets Level 2 To Level 1Transfers Amount 1	$ 0	$ 0

Fair Value Measurements - Summa

Fair Value Measurements - Summary of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Details) - Fair Value on Recurring Basis - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Level 1 | Warrant Liability
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total liabilities at fair value	$ 0	$ 0
Level 1 | Embedded Derivative
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total liabilities at fair value	0	0
Level 2 | Warrant Liability
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total liabilities at fair value	0	0
Level 2 | Embedded Derivative
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total liabilities at fair value	0	0
Level 3 | Warrant Liability
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total liabilities at fair value	18,688	40,834
Level 3 | Embedded Derivative
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total liabilities at fair value	$ 35,018	$ 22,899

Fair Value Measurements - Sum_2

Fair Value Measurements - Summary of Inputs and Assumptions used to Determine Fair Value of Warrant Liability (Details)	Sep. 30, 2024 $ / shares	Dec. 31, 2023 $ / shares
Derivative Financial Instruments Liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Share Price	$ 5	$ 13.5
Level 3 | Warrant Liability
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Share Price	5	$ 13.5
Level 3 | Warrant Liability | Monte Carlo Simulation [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Share Price	$ 5
Level 3 | Warrant Liability | Minimum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Expected life (years)	1 year 10 months 24 days	2 years 6 months
Level 3 | Warrant Liability | Minimum | Monte Carlo Simulation [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Expected life (years)	3 years 10 months 24 days
Level 3 | Warrant Liability | Maximum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Expected life (years)	5 years	5 years
Level 3 | Warrant Liability | Maximum | Monte Carlo Simulation [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Expected life (years)	5 years
Risk-free interest rate | Derivative Financial Instruments Liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value of embedded derivative liability range	0.35
Risk-free interest rate | Minimum | Derivative Financial Instruments Liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value of embedded derivative liability range		0.38
Risk-free interest rate | Maximum | Derivative Financial Instruments Liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value of embedded derivative liability range		0.43
Risk-free interest rate | Level 3 | Warrant Liability | Monte Carlo Simulation [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement inputs	0.36
Risk-free interest rate | Level 3 | Warrant Liability | Minimum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement inputs	0.36	0.38
Risk-free interest rate | Level 3 | Warrant Liability | Maximum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement inputs	0.37	0.41
Expected volatility | Derivative Financial Instruments Liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value of embedded derivative liability range	9.19
Expected volatility | Minimum | Derivative Financial Instruments Liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value of embedded derivative liability range		8.43
Expected volatility | Maximum | Derivative Financial Instruments Liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value of embedded derivative liability range		9.57
Expected volatility | Level 3 | Warrant Liability | Minimum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement inputs	7.63	9.56
Expected volatility | Level 3 | Warrant Liability | Minimum | Monte Carlo Simulation [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement inputs	9.35
Expected volatility | Level 3 | Warrant Liability | Maximum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement inputs	9.47	10.18
Expected volatility | Level 3 | Warrant Liability | Maximum | Monte Carlo Simulation [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement inputs	9.42
Measurement input discount rate | Derivative Financial Instruments Liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value of embedded derivative liability range	4.07
Measurement input discount rate | Minimum | Derivative Financial Instruments Liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value of embedded derivative liability range		2.87
Measurement input discount rate | Maximum | Derivative Financial Instruments Liabilities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair Value of embedded derivative liability range		2.89

Fair Value Measurements - Sum_3

Fair Value Measurements - Summary of Changes in Warrant Liabilities (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2024 USD ($)
Derivative Liabilities [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Balance at December 31, 2023	$ 22,899
Extinguishment of derivative liabilities	(37,040)
Recognition of warrant liabilities and derivative liabilities	57,828
Change in fair value	(8,669)
Balance at September 30, 2024	35,018
Warrant [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Balance at December 31, 2023	40,834
Recognition of warrant liabilities	11,405
Reclassification of warrant liabilities to equity	(1,062)
Reclassification to warrant liabilities from equity	45
Expired warrants	(1,460)
Warrant reprice adjustment	4,938
Change in fair value	$ (36,012)
Fair Value, Liability, Recurring Basis, Unobservable Input Reconciliation, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	Fair Value Adjustment of Warrants
Balance at September 30, 2024	$ 18,688

Convertible Notes - Summary of

Convertible Notes - Summary of Significant Terms of Company's Convertible Notes (Details) - USD ($) $ in Thousands	Sep. 30, 2024		Mar. 08, 2024	Dec. 31, 2023		Dec. 31, 2020
Debt Instrument [Line Items]
2028 Convertible Notes	$ 14,344	[1]		$ 0
2028 Convertible Notes	0			14,591
Related Party 2028 Convertible Notes	19,721	[2]		21,155
2025 Convertible Notes	4,527			0
2025 Convertible Notes	0			9,966
Non-Affiliate 2028 Convertible Notes
Debt Instrument [Line Items]
Face Value	39,901	[1]		23,500
Fair Value	$ 14,807	[1],[3]		$ 14,846	[4]
Effective Interest Rate	50.90%	[1]		48.90%
Non-Affiliate 2028 Convertible Notes | Minimum
Debt Instrument [Line Items]
Interest rate	11%	[1]		11%
Non-Affiliate 2028 Convertible Notes | Maximum
Debt Instrument [Line Items]
Interest rate	13%	[1]		13%
Related Party 2028 Convertible Notes
Debt Instrument [Line Items]
Face Value	$ 18,400	[2]		$ 17,383
Fair Value	$ 5,853	[2],[3]		$ 10,982	[4]
Effective Interest Rate	24.70%	[2]		22%
Related Party 2028 Convertible Notes | Minimum
Debt Instrument [Line Items]
Interest rate	11%	[2]		11%
Related Party 2028 Convertible Notes | Maximum
Debt Instrument [Line Items]
Interest rate	13%	[2]		13%
2025 Convertible Notes
Debt Instrument [Line Items]
Face Value	$ 4,600		$ 5,600	$ 10,225		$ 168,500
Fair Value	$ 2,676	[3]		$ 5,984	[4]
Interest rate	7.25%			7.25%		7.25%
Effective Interest Rate	8.70%			8.70%
[1] (2) The face value includes $ 24.0 million in Payment Priority Notes (as defined below) and $ 1.8 million in PIK Notes (as defined below). (3) The face value includes $ 5.5 million in Payment Priority Notes (as defined below) and $ 1.0 million in PIK Notes (as defined below). (1) To estimate the fair value of the Non-Affiliate 2028 Convertible Notes, the Company used a binomial pricing model. Including the derivative liabilities of $ 23.0 million, the Non-Affiliate 2028 Convertible Notes fair value using the with method is $ 37.8 million. To estimate the fair value of the Related Party 2028 Convertible Notes, the Company used a binomial pricing model. Including the derivative liabilities of $ 12.1 million, the Non-Affiliate 2028 Convertible Notes fair value using the with method is $ 17.9 million. To estimate the fair value of the 2025 Convertible Notes, the Company used unadjusted quoted prices in the active market obtained from third-party pricing services. (4) To estimate the fair value of the 2028 Convertible Notes, the Company used a binomial pricing model. Including the derivative liabilities of $ 22.9 million, the 2028 Convertible Notes fair value using the with method is $ 48.7 million. To estimate the fair value of the 2025 Convertible Notes, the Company used unadjusted quoted prices in the active market obtained from third-party pricing services.

Convertible Notes - Summary o_2

Convertible Notes - Summary of Significant Terms of Company's Convertible Notes (Parenthetical) (Details) - USD ($) $ in Thousands	Sep. 30, 2024		Mar. 08, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Derivative liabilities	$ 0			$ 22,899
2028 Convertible Notes
Debt Instrument [Line Items]
Face Value			$ 3,800
Non-Affiliate 2028 Convertible Notes
Debt Instrument [Line Items]
Derivative liabilities	23,000			22,900
Fair value	37,800			48,700
Face Value	39,901	[1]		23,500
Non-Affiliate 2028 Convertible Notes | Payment Priority Notes
Debt Instrument [Line Items]
Face Value	24,000
Non-Affiliate 2028 Convertible Notes | Payment in Kind (PIK) Note
Debt Instrument [Line Items]
Face Value	1,800
Related Party 2028 Convertible Notes
Debt Instrument [Line Items]
Derivative liabilities	12,100
Fair value	17,900
Face Value	18,400	[2]		$ 17,383
Related Party 2028 Convertible Notes | Payment Priority Notes
Debt Instrument [Line Items]
Face Value	5,500
Related Party 2028 Convertible Notes | Payment in Kind (PIK) Note
Debt Instrument [Line Items]
Face Value	$ 1,000
[1] (2) The face value includes $ 24.0 million in Payment Priority Notes (as defined below) and $ 1.8 million in PIK Notes (as defined below). (3) The face value includes $ 5.5 million in Payment Priority Notes (as defined below) and $ 1.0 million in PIK Notes (as defined below).

Convertible Notes - Additional

Convertible Notes - Additional Information (Details) $ / shares in Units, $ in Thousands				1 Months Ended					3 Months Ended						9 Months Ended		12 Months Ended
	Aug. 12, 2024 USD ($) $ / shares shares	Jul. 03, 2024 $ / shares shares	Mar. 08, 2024 USD ($) $ / shares shares	Sep. 30, 2024 USD ($) $ / shares shares	May 31, 2024 USD ($)	Dec. 31, 2023 USD ($) $ / shares shares	Sep. 30, 2023 USD ($) $ / shares shares	Dec. 31, 2020 USD ($) $ / shares	Sep. 30, 2024 USD ($) $ / shares shares	Jun. 30, 2024 shares	Mar. 31, 2024 $ / shares shares	Sep. 30, 2023 USD ($) $ / shares shares	Jun. 30, 2023 $ / shares shares	Mar. 31, 2023 shares	Sep. 30, 2024 USD ($) TradingDays Warrants $ / shares shares	Sep. 30, 2023 USD ($) $ / shares shares	Dec. 31, 2023 USD ($) $ / shares shares	Aug. 15, 2024 USD ($)	Oct. 31, 2023 USD ($)	Oct. 12, 2023 $ / shares shares	Oct. 10, 2023 $ / shares shares	Sep. 18, 2023 USD ($)
Debt Instrument [Line Items]
Interest expense									$ 2,016			$ 2,592			$ 5,484	$ 7,975
Issuance of common stock upon conversion of debt							$ 50,000					66,699
Warrants issued | shares				7,141,572					7,141,572				301,886		7,141,572					427,807	100,000
Class Of warrant or right, period for warrants or rights exercisable																after September 18, 2023 until September 18, 2026
Warrants exercise price per share | $ / shares													$ 50.5							$ 18.7	$ 19.3
Date from which warrants are exercisable															Apr. 01, 2024
Restructuring gain																	$ 25,500
Future interest payments included in restructured senior secured convertible notes																	11,700
Loss on extinguishment															$ (10,890)	$ 0
Inducement loss on convertible notes							$ 53,200								0	53,198
Warrant liabilities				$ 35,018		$ 0			$ 35,018						35,018		0		$ 6,700			$ 35,100
Amortization of debt discount															3,216	1,126
Purchase price															$ 10,813	$ 0
Forbearance agreement, maturity date															Oct. 31, 2024
Note Purchase Agreements
Debt Instrument [Line Items]
Warrants issued | shares	677,777		200,000
Warrants exercise price per share | $ / shares	$ 6		$ 27.5
Date from which warrants are exercisable			Sep. 12, 2024
Warrants maturity date			Mar. 12, 2029
Amended Warrants [Member]
Debt Instrument [Line Items]
Class of Warrant or Right, Outstanding | shares	2,291,445										641,582
Warrants exercise price per share | $ / shares	$ 6										$ 11
Convertible Notes
Debt Instrument [Line Items]
Loss on extinguishment			$ 200														$ 6,400
Maximum
Debt Instrument [Line Items]
Beneficial ownership, Limitation to exercise warrants percentage																49.90%
Forbearance Agreement
Debt Instrument [Line Items]
Warrants issued | shares		124,996
Debt Exchange Transactions Agreement
Debt Instrument [Line Items]
Restructuring gain	$ 0
Loss on extinguishment									(8,700)						$ (8,700)
September Drawdown Agreement
Debt Instrument [Line Items]
Restructuring gain				$ 0
Loss on extinguishment									$ (2,000)						$ (2,000)
September Drawdown Agreement | Note Purchase Agreements
Debt Instrument [Line Items]
Warrants issued | shares				675,552					675,552						675,552
Warrants exercise price per share | $ / shares				$ 6					$ 6						$ 6
Common Stock
Debt Instrument [Line Items]
Issuance of common stock upon conversion of debt												$ 1
Issuance of stock, net, shares | shares							923,528		52,581	545,454	259,158	8,291	150,943	285,310
Warrants exercise price per share | $ / shares							$ 30.1					$ 30.1				$ 30.1
Common Stock | Maximum
Debt Instrument [Line Items]
Class of Warrant or Right, Outstanding | shares							1,663,449					1,663,449				1,663,449
Common Stock | Note Exchange Agreements
Debt Instrument [Line Items]
Issuance of stock, net, shares | shares						62,500
Pre Funded Warrants
Debt Instrument [Line Items]
Warrants issued | shares							739,921					739,921				739,921
Warrants exercise price per share | $ / shares							$ 0.01					$ 0.01				$ 0.01
Exchange Warrant
Debt Instrument [Line Items]
Warrants exercise price per share | $ / shares						$ 55											$ 55
Date from which warrants are exercisable																	Dec. 19, 2023
Warrants maturity date						Dec. 19, 2028											Dec. 19, 2028
Exchange Warrant | Note Exchange Agreements | Maximum
Debt Instrument [Line Items]
Class of Warrant or Right, Outstanding | shares						503,922											503,922
Additional Warrants
Debt Instrument [Line Items]
Warrants issued | shares						508,460											508,460
Warrants exercise price per share | $ / shares						$ 50											$ 50
Date from which warrants are exercisable																	Dec. 19, 2023
Warrants maturity date						Dec. 19, 2028											Dec. 19, 2028
Commitment Warrants
Debt Instrument [Line Items]
Warrants issued | shares						735,292											735,292
Warrants exercise price per share | $ / shares						$ 13.6											$ 13.6
Date from which warrants are exercisable																	Jun. 19, 2024
Warrants maturity date						Dec. 19, 2028											Dec. 19, 2028
Forbearance warrants
Debt Instrument [Line Items]
Warrants exercise price per share | $ / shares		$ 6.3
Date from which warrants are exercisable		Jul. 03, 2024
Warrants maturity date		Oct. 31, 2029
December 2023 Warrants
Debt Instrument [Line Items]
Warrants exercise price per share | $ / shares				$ 11					$ 11						$ 11
Amendment of warrants description															In connection with the March 2024 Offering (as defined below), 232,205 of the December 2023 Warrants were amended to (i) lower the exercise price to $11.00 per share, (ii) provide that the warrants were not exercisable until June 5, 2024 (the "Stockholder Approval Date") and (iii) extend the original expiration date to be five years from the Stockholder Approval Date.
Number of warrants amended | Warrants															232,205
Warrants expire term				5 years					5 years						5 years
7.25% Convertible Senior Notes due 2025
Debt Instrument [Line Items]
Principal amount			5,600	$ 4,600		$ 10,225		$ 168,500	$ 4,600						$ 4,600		$ 10,225
Debt instrument, annual interest rate				7.25%		7.25%		7.25%	7.25%						7.25%		7.25%
Debt instrument, issuance date								Dec. 07, 2020
Debt instrument, frequency of periodic payment								semi-annually
Debt instrument due date								Dec. 01, 2025
Debt instrument, initial payment date								Jun. 01, 2021
Interest expense									$ 100			$ 2,300			$ 300	$ 7,100
Debt instrument, convertible, initial conversion rate per $1,000 principal amount of convertible notes								1.11204
Debt instrument convertible initial conversion price | $ / shares								$ 899.25
Debt instrument, redemption period, start date															Dec. 01, 2023
Debt instrument, convertible, threshold percentage of stock price trigger															130%
Debt instrument, convertible, threshold trading days | TradingDays															20
Debt instrument, convertible, threshold consecutive trading days | TradingDays															30
Events of default, description															The 2025 Convertible Notes have customary provisions relating to the occurrence of “Events of Default” (as defined in the 2025 Convertible Notes Indenture).
Unamortized discount				$ 100		$ 300			100						$ 100		$ 300
7.25% Convertible Senior Notes due 2025 | Interest Expense
Debt Instrument [Line Items]
Amortization of debt discount									$ 100			$ 400			$ 100	$ 1,100
7.25% Convertible Senior Notes due 2025 | Note Exchange Agreements
Debt Instrument [Line Items]
Principal amount						72,500											72,500
2028 Convertible Notes
Debt Instrument [Line Items]
Principal amount			3,800
Debt instrument, annual interest rate				11%					11%						11%
Paid in kind interest rate				13%					13%						13%
Debt instrument, issuance date															Dec. 19, 2023
Debt instrument due date															Dec. 19, 2028
Debt instrument, initial payment date															Jun. 01, 2024
Interest expense					$ 2,800				$ 1,000						$ 2,500
Debt instrument, convertible, initial conversion rate per $1,000 principal amount of convertible notes															64.1026
Debt instrument convertible initial conversion price | $ / shares				$ 15.6					$ 15.6						$ 15.6
Debt instrument, redemption period, start date															Dec. 19, 2024
Debt instrument, convertible, threshold percentage of stock price trigger															150%
Debt instrument, convertible, threshold trading days | TradingDays															20
Debt instrument, convertible, threshold consecutive trading days | TradingDays															30
Unamortized discount				$ 43,400		19,000			$ 43,400						$ 43,400		19,000
2028 Convertible Notes | Interest Expense
Debt Instrument [Line Items]
Amortization of debt discount									900						3,200
2028 Convertible Notes | Note Purchase Agreements
Debt Instrument [Line Items]
Principal amount			$ 2,800			17,000											17,000
2028 Convertible Notes | Minimum
Debt Instrument [Line Items]
Principal amount				5,000					5,000						5,000
2028 Convertible Notes | Minimum | Payment in Kind (PIK) Note
Debt Instrument [Line Items]
Debt instrument, annual interest rate					11%
2028 Convertible Notes | Maximum | Payment in Kind (PIK) Note
Debt Instrument [Line Items]
Debt instrument, annual interest rate					13%
2028 Convertible Notes | Note Exchange Agreements
Debt Instrument [Line Items]
Principal amount	10,800			$ 10,800		$ 23,900			$ 10,800						$ 10,800		$ 23,900
A&R Indenture
Debt Instrument [Line Items]
Debt instrument, issuance date															Dec. 19, 2023
Debt instrument, convertible, initial conversion rate per $1,000 principal amount of convertible notes															132.1571
Debt instrument convertible initial conversion price | $ / shares				$ 7.56675					$ 7.56675						$ 7.56675
Minimum liquidity requirement/Covenant															$ 4,000
Events of default, description															The 2028 Convertible Notes have customary provision relating to the occurrence of “Events of Default” (as defined in the A&R Indenture).
Payment Priority Notes | Note Purchase Agreements
Debt Instrument [Line Items]
Principal amount	16,000																	$ 16,000
Purchase price	$ 4,000
Payment Priority Notes | Note Exchange Agreements
Debt Instrument [Line Items]
Principal amount				$ 10,800					$ 10,800						$ 10,800			$ 10,800
Payment Priority Notes | September Drawdown Agreement | Note Purchase Agreements
Debt Instrument [Line Items]
Principal amount				$ 4,000					$ 4,000						$ 4,000

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands		1 Months Ended		3 Months Ended						6 Months Ended	9 Months Ended
	Jun. 01, 2024	Sep. 30, 2023	Jun. 30, 2023	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Aug. 31, 2024	Aug. 12, 2024	May 31, 2024	Dec. 31, 2023	Oct. 12, 2023	Oct. 10, 2023	Jan. 31, 2023	Jan. 12, 2023	Nov. 30, 2022
Related Party Transaction [Line Items]
Issuance of common stock upon conversion of debt		$ 50,000					$ 66,699
Common stock, shares outstanding				3,677,726							3,677,726					2,783,748
Warrants issued			301,886	7,141,572				301,886		301,886	7,141,572						427,807	100,000
Warrants exercise price per share			$ 50.5					$ 50.5		$ 50.5							$ 18.7	$ 19.3
Interest expense				$ 2,016			$ 2,592				$ 5,484	$ 7,975
2028 Convertible Notes
Related Party Transaction [Line Items]
Principal amount				$ 2,800							2,800		$ 2,800
Securities Purchase Agreement | Maximum
Related Party Transaction [Line Items]
Common stock outstanding, percentage		5%					5%		5%			5%
Securities Purchase Agreement
Related Party Transaction [Line Items]
Common stock outstanding, percentage			5%					5%		5%											5%
Shares issued, price per share			$ 53					$ 53		$ 53
Warrants issued			301,886					301,886		301,886									9,000	9,000
Warrants exercise price per share																			$ 82.2
Amended Warrants
Related Party Transaction [Line Items]
Class of Warrant or Right, Outstanding						641,582								2,291,445
Warrants exercise price per share						$ 11								$ 6
Exchange Warrant
Related Party Transaction [Line Items]
Warrants exercise price per share																$ 55
Common Stock
Related Party Transaction [Line Items]
Issuance of common stock upon conversion of debt							$ 1
Issuance of common stock		923,528		52,581	545,454	259,158	8,291	150,943	285,310
Common stock issued and sold			150,943
Warrants exercise price per share		$ 30.1					$ 30.1					$ 30.1
Common Stock | Maximum
Related Party Transaction [Line Items]
Class of Warrant or Right, Outstanding		1,663,449					1,663,449					1,663,449
Common Stock | Securities Purchase Agreement
Related Party Transaction [Line Items]
Common stock issued and sold						545,454				150,943
Additional Warrants
Related Party Transaction [Line Items]
Warrants issued																508,460
Warrants exercise price per share																$ 50
Pre- funded Warrants
Related Party Transaction [Line Items]
Warrants issued		739,921					739,921					739,921
Warrants exercise price per share		$ 0.01					$ 0.01					$ 0.01
Note Exchange Agreements | Payment Priority Notes
Related Party Transaction [Line Items]
Principal amount				$ 2,800							$ 2,800		$ 2,800
Athyrium
Related Party Transaction [Line Items]
Common stock, shares outstanding				1,092,975							1,092,975					1,092,976
Common stock outstanding, percentage				29.70%							29.70%					39.30%
Aggregate principal amount of convertible notes				$ 18,400							$ 18,400
Interest expense	$ 1,000
Athyrium | Payment in Kind (PIK) Note
Related Party Transaction [Line Items]
Aggregate principal amount of convertible notes				$ 1,000							$ 1,000
Athyrium | 2025 Convertible Notes
Related Party Transaction [Line Items]
Issuance of common stock upon conversion of debt												$ 50,000
Athyrium | 2028 Convertible Notes
Related Party Transaction [Line Items]
Aggregate principal amount of convertible notes																$ 17,400
Athyrium | Amended Warrants
Related Party Transaction [Line Items]
Class of Warrant or Right, Outstanding															840,595
Warrants exercise price per share															$ 6
Athyrium | Warrants
Related Party Transaction [Line Items]
Class of Warrant or Right, Outstanding		1,663,449					1,663,449					1,663,449
Athyrium | Warrants | Maximum
Related Party Transaction [Line Items]
Class of Warrant or Right, Outstanding				2,504,044							2,504,044					2,458,320
Warrants exercise price per share				$ 30.1							$ 30.1					$ 82.2
Athyrium | Warrants | Minimum
Related Party Transaction [Line Items]
Warrants exercise price per share				$ 6							$ 6					$ 30.1
Athyrium | Common Stock | 2025 Convertible Notes
Related Party Transaction [Line Items]
Warrants exercise price per share		$ 30.1					$ 30.1					$ 30.1
Athyrium | Pre- funded Warrants
Related Party Transaction [Line Items]
Class of Warrant or Right, Outstanding				739,921							739,921					739,921

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) $ in Millions				1 Months Ended	9 Months Ended
	Jul. 01, 2024 USD ($)	Dec. 22, 2020 Case	Dec. 03, 2020 Case	Oct. 31, 2024 USD ($)	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	Jul. 21, 2020 State
Commitment And Contingencies [Line Items]
cash paid for operating leases					$ 0.8	$ 0.9
Number of states participating in settlement | State							45
Payments for settlements related to agreement	$ 2.3			$ 0.3	2.8	$ 1.7
Number of actions pending | Case		2	2
Litigation expense					1
Accrued Expenses And Other Current Liabilities
Commitment And Contingencies [Line Items]
Remaining accrual balance					$ 2.6
SDNY Civil Settlement Agreement
Commitment And Contingencies [Line Items]
Interest rate	1.25%

Commitments and Contingencies_2

Commitments and Contingencies - components of lease expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Operating lease costs	$ 235	$ 311	$ 706	$ 1,104

Commitments and Contingencies_3

Commitments and Contingencies - Supplemental weighted-average information related to operating leases (Details)	Sep. 30, 2024	Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Weighted-average remaining lease term (years)	1 year 7 months 6 days	2 years 3 months 18 days
Weighted-average discount rate	9.50%	9.70%

Commitments and Contingencies_4

Commitments and Contingencies - Schedule of Net Minimum Payments Under Non-Cancelable Operating Leases (Details) $ in Thousands	Sep. 30, 2024 USD ($)
Commitments and Contingencies Disclosure [Abstract]
2024 (remaining)	$ 259
2025	590
2026	264
2027	18
2028 and thereafter	0
Total minimum lease payments	1,131
Less: interest	$ (77)
Operating Lease, Liability, Statement of Financial Position [Extensible Enumeration]	Accrued Expenses And Other Liabilities Current
Present value of lease liabilities	$ 1,054

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Details) $ / shares in Units, $ in Thousands								1 Months Ended						3 Months Ended						6 Months Ended	9 Months Ended
	Oct. 18, 2024 shares	Jul. 01, 2024 USD ($)	Jan. 31, 2024 USD ($) shares	Oct. 09, 2023 USD ($)	Jan. 03, 2023 shares	Dec. 19, 2022 shares	Nov. 10, 2022 Vote $ / shares	Oct. 31, 2023 USD ($)	Sep. 30, 2023 $ / shares shares	Jun. 30, 2023 USD ($) $ / shares shares	Jan. 31, 2023 $ / shares shares	Nov. 30, 2022 USD ($)	Nov. 30, 2021 USD ($)	Sep. 30, 2024 USD ($) shares	Jun. 30, 2024 USD ($) shares	Mar. 31, 2024 USD ($) $ / shares shares	Sep. 30, 2023 $ / shares shares	Jun. 30, 2023 USD ($) $ / shares shares	Mar. 31, 2023 shares	Jun. 30, 2023 USD ($) $ / shares shares	Sep. 30, 2024 USD ($) shares	Sep. 30, 2023 USD ($) $ / shares shares	Aug. 12, 2024 $ / shares shares	Jun. 05, 2024 shares	Dec. 31, 2023 USD ($) shares	Oct. 12, 2023 $ / shares shares	Oct. 10, 2023 $ / shares shares	Sep. 18, 2023 USD ($)	Jan. 12, 2023 shares
Class Of Stock [Line Items]
Common stock authorized to issue														300,000,000							300,000,000				164,000,000
Shares issued, price per share | $ / shares										$ 53								$ 53		$ 53
Proceeds from issuance of common stock, net | $										$ 7,300											$ 6,465	$ 13,064
Net proceeds from issue of shares and warrants | $															$ 5,500
Adjusted common stock purchase warrant to purchase shares of common stock										301,886				7,141,572				301,886		301,886	7,141,572					427,807	100,000
Warrants exercise price per share | $ / shares										$ 50.5								$ 50.5		$ 50.5						$ 18.7	$ 19.3
Date from which warrants are exercisable																					Apr. 01, 2024
Common stock value subscriptions | $								$ 9,900
Proceeds from issuance of common stock warrants | $										$ 8,000											$ 2,819	$ 8,000
Total issuance cost | $										700						$ 700
Gain loss on warrant liability | $			$ 1,500					6,700		$ 1,000
Reverse stock split description	1-for-10 reverse split				On January 3, 2023, the Company effected the 2023 Reverse Stock Split of the Company's common stock.
Warrant liabilities | $								$ 6,700						$ 35,018							$ 35,018				$ 0			$ 35,100
Number of vote per preferred stock held | Vote							3,000
One Point Nine Three Per Share [Member]
Class Of Stock [Line Items]
Adjusted common stock purchase warrant to purchase shares of common stock			84,836
One Point Eight Seven Per Share [Member]
Class Of Stock [Line Items]
Adjusted common stock purchase warrant to purchase shares of common stock			137,868
Amended Warrants [Member]
Class Of Stock [Line Items]
Warrants exercise price per share | $ / shares																$ 11							$ 6
Class of Warrant or Right, Outstanding																641,582							2,291,445
Series X Preferred Stock
Class Of Stock [Line Items]
Preferred stock, par value | $ / shares							$ 0.001
Preferred stock, shares outstanding						136,961									136,961
Redeemable Preferred Stock
Class Of Stock [Line Items]
Stock redeemed or called during period, shares						86,210
Undesignated Preferred Stock
Class Of Stock [Line Items]
Preferred stock, shares authorized														10,000,000							10,000,000
Amended March 2024 Offering
Class Of Stock [Line Items]
Warrants exercise price per share | $ / shares																$ 11
March 2024 Offering
Class Of Stock [Line Items]
Sale of stock closing date																Apr. 01, 2024
Securities Purchase Agreement
Class Of Stock [Line Items]
Shares issued, price per share | $ / shares																$ 11
Adjusted common stock purchase warrant to purchase shares of common stock										301,886	9,000							301,886		301,886									9,000
Warrants exercise price per share | $ / shares											$ 82.2
Date from which warrants are exercisable											May 09, 2023
Warrant liabilities | $										$ 9,000								$ 9,000		$ 9,000
Sale Agreement
Class Of Stock [Line Items]
Common stock issued and sold														52,581			8,292				311,739	293,603
Sale Agreement | B Riley Securities, Inc [Member]
Class Of Stock [Line Items]
Rate of commission proposed for agents													3%
Aggregate offering price | $				$ 37,600								$ 70,000	$ 90,000								$ 12,000
Canaccord Genuity LLC | Sale Agreement
Class Of Stock [Line Items]
Rate of commission proposed for agents		3%
Aggregate offering price | $		$ 90,000
Common stock aggregate gross sales price | $		$ 6,000
Common Stock
Class Of Stock [Line Items]
Common stock authorized to issue					164,000,000
Common stock issued and sold										150,943
Issuance of stock, net, shares									923,528					52,581	545,454	259,158	8,291	150,943	285,310
Warrants exercise price per share | $ / shares									$ 30.1								$ 30.1					$ 30.1
Common Stock | Minimum
Class Of Stock [Line Items]
Common stock authorized to issue	300,000,000																							164,000,000
Common Stock | Maximum
Class Of Stock [Line Items]
Common stock authorized to issue	255,000,000																							300,000,000
Class of Warrant or Right, Outstanding									1,663,449								1,663,449					1,663,449
Common Stock | Securities Purchase Agreement
Class Of Stock [Line Items]
Common stock issued and sold																545,454				150,943
Private Placement | Securities Purchase Agreement
Class Of Stock [Line Items]
Warrants exercise price per share | $ / shares																$ 11
Private Placement | Common Stock
Class Of Stock [Line Items]
Adjusted common stock purchase warrant to purchase shares of common stock																545,454

Stockholders' Equity - Schedule

Stockholders' Equity - Schedule of Warrants Outstanding to Acquire Shares of its Common Stock (Details) - $ / shares	Sep. 30, 2024	Oct. 12, 2023	Oct. 10, 2023	Jun. 30, 2023
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	7,141,572	427,807	100,000	301,886
Warrants exercise price per share		$ 18.7	$ 19.3	$ 50.5
Related Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	3,243,965
Nonrelated Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	3,897,607
Expiration Date Not Applicable [Member] | Related Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	739,921
Warrants exercise price per share	$ 0.01
September 2026 | Related Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	1,663,449
Warrants exercise price per share	$ 30.1
September 2029 | Nonrelated Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	368,568
Warrants exercise price per share	$ 6
November 2029 | Nonrelated Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	1,353,329
Warrants exercise price per share	$ 6
February 2026 | Nonrelated Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	6,993
Warrants exercise price per share	$ 1,715
August 2026 | Nonrelated Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	45,263
Warrants exercise price per share	$ 250
April 2027 | Nonrelated Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	137,868
Warrants exercise price per share	$ 18.7
April 2027 One | Nonrelated Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	84,836
Warrants exercise price per share	$ 19.3
March 2029 | Related Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	712,459
Warrants exercise price per share	$ 6
March 2029 One | Nonrelated Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	803,010
Warrants exercise price per share	$ 6
October 2029 | Related Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	45,724
Warrants exercise price per share	$ 6
October 2029 | Nonrelated Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	79,272
Warrants exercise price per share	$ 6
August 2028 | Related Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	82,412
Warrants exercise price per share	$ 6
June 2029 | Nonrelated Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	200,000
Warrants exercise price per share	$ 6
June 2029 One | Nonrelated Party [Member]
Class of Stock [Line Items]
Class of Warrant or Right, Number of Securities Called by Warrants or Rights	818,468
Warrants exercise price per share	$ 11

Stockholders' Equity - Schedu_2

Stockholders' Equity - Schedule of Shares Sold Under the ATM Sale Agreement (Details) - Sale Agreement - USD ($) $ / shares in Units, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Class of Stock [Line Items]
Net proceeds (in millions)	$ 0.4	$ 0.2	$ 3.2	$ 12.7
Number of shares	52,581	8,292	311,739	293,603
Weighted average purchase price	$ 6.9	$ 21.86	$ 10.86	$ 45.45

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended	3 Months Ended		9 Months Ended
	Nov. 30, 2024	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Jun. 14, 2023	Nov. 03, 2021	Feb. 28, 2018
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock-based compensation expense		$ 1,281	$ 10,531	$ 4,393	$ 14,929
Weighted-average grant date fair value of options granted				$ 5.5	$ 28.76
Unrecognized compensation cost related to unvested stock options expected to be recognized amount		3,800		$ 3,800
Unrecognized compensation cost related to unvested stock options expected to be recognized over remaining weighted average vesting period				2 years 2 months 12 days
Restricted Stock Units (RSUs)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock-based compensation expense			$ 7,900
Unrecognized compensation cost related to unvested stock options expected to be recognized over remaining weighted average vesting period				3 years 2 months 12 days
Unrecognized compensation cost related to restricted stock options expected to be recognized amount		$ 7,100		$ 7,100
2012 Stock Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock options issuable under the plan								0
2018 Equity Incentive Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares available for future grant		511,562		511,562
Common stock shares reserved for future issuance						550,000
2018 Equity Incentive Plan | Forecast
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Increased number of shares authorized for issuance	1,850,000
Extended term of the plan	Oct. 10, 2034
Inducement Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares available for future grant							26,000
2021 Inducement Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares available for future grant		6,779		6,779

Stock-Based Compensation - Summ

Stock-Based Compensation - Summary of Stock Options Activity under Plans (Details) $ / shares in Units, $ in Thousands	9 Months Ended
	Sep. 30, 2024 USD ($) $ / shares shares
Share-Based Payment Arrangement [Abstract]
Stock Options Outstanding Balance at December 31, 2023 | shares	76,301
Stock Options Outstanding Options granted | shares	10,880
Stock Options Outstanding Options exercised | shares	0
Stock Options Outstanding Options forfeited/cancelled | shares	(3,795)
Stock Options Outstanding Balance at September 30, 2024 | shares	83,386
Stock Options Outstanding Vested and expected to vest at September 30, 2024 | shares	83,386
Stock Options Outstanding Vested and exercisable at September 30, 2024 | shares	44,243
Weighted-Average Exercise Price Balance at December 31, 2023 | $ / shares	$ 362.33
Weighted-Average Exercise Price Options granted | $ / shares	6.52
Weighted-Average Exercise Price Options exercised | $ / shares	0
Weighted-Average Exercise Price Options forfeited/cancelled | $ / shares	248.08
Weighted-Average Exercise Price Balance at September 30, 2024 | $ / shares	321.11
Weighted-Average Exercise Price Vested and expected to vest at September 30, 2024 | $ / shares	321.11
Weighted-Average Exercise Price Vested and exercisable at September 30, 2024 | $ / shares	$ 480.71
Weighted-Average Remaining Contractual Term (in years) Balance at September 30, 2024	7 years 10 months 24 days
Weighted-Average Remaining Contractual Term (in years) Vested and expected to vest at September 30, 2024	7 years 10 months 24 days
Weighted-Average Remaining Contractual Term (in years) Vested and exercisable at September 30, 2024	7 years 2 months 12 days
Aggregate Intrinsic Value Balance at September 30, 2024 | $	$ 0
Aggregate Intrinsic Value Vested and expected to vest at September 30, 2024 | $	0
Aggregate Intrinsic Value Vested and exercisable at September 30, 2024 | $	$ 0

Stock-Based Compensation - Su_2

Stock-Based Compensation - Summary of Assumptions used to Determine Fair Value of Stock Options Granted (Details)	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Risk-free interest rate, minimum	3.60%	3.50%
Risk-free interest rate, maximum	4.70%	4.40%
Expected volatility, minimum	92.80%	98.50%
Expected volatility, maximum	96.80%	102.70%
Expected dividend yield	0%	0%
Minimum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected life (years)	5 years 6 months	5 years 6 months
Maximum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected life (years)	6 years 3 months 18 days	6 years 3 months 18 days

Stock-Based Compensation - Su_3

Stock-Based Compensation - Summary of Restricted Stock Units Activity (Details) - Restricted Stock Units (RSUs)	9 Months Ended
	Sep. 30, 2024 $ / shares shares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of Shares, Beginning Balance | shares	253,735
Number of Shares, Granted | shares	281,300
Number of Shares, Vested | shares	(63,354)
Number of Shares, Forfeited/cancelled | shares	(19,865)
Number of Shares, Ending Balance | shares	451,816
Weighted Average Grant Date Fair Value beginning of period | $ / shares	$ 33.07
Weighted Average Grant Date Fair Value, Granted | $ / shares	8.02
Weighted Average Grant Date Fair Value, Vested | $ / shares	33.54
Weighted Average Grant Date Fair Value, Forfeited/cancelled | $ / shares	38.43
Weighted Average Grant Date Fair Value end of period | $ / shares	$ 17.17

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Stock-based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total Stock-based compensation expense	$ 1,281	$ 10,531	$ 4,393	$ 14,929
Research and Development
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total Stock-based compensation expense	682	4,680	1,970	6,308
Selling, General and Administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total Stock-based compensation expense	$ 599	$ 5,851	$ 2,423	$ 8,621

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Tax [Line Items]
Effective tax rate	0%	0%	0%	0%
Maximum
Income Tax [Line Items]
Testing period for ownership change			3 years
Minimum
Income Tax [Line Items]
Percentage of shift in stock ownership to determine whether ownership change occurred			50%
Percentage of shareholders ownership			5%

Net Loss Per Share - Summary of

Net Loss Per Share - Summary of Potentially Dilutive Securities Not Included in Calculation of Diluted Loss Per Share (Details) - shares	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive securities not included in calculation of diluted loss per share	15,387,216	3,378,248
Stock Options To Purchase Common Stock
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive securities not included in calculation of diluted loss per share	83,386	73,249
Restricted Stock Units (RSUs)
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive securities not included in calculation of diluted loss per share	451,816	256,451
Common Stock Warrants and Pre-funded Warrants
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive securities not included in calculation of diluted loss per share	7,141,572	2,947,419
Common Stock Issuable Upon Conversion of Convertible Notes
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive securities not included in calculation of diluted loss per share	7,710,442	101,129

Subsequent Events - Additional

Subsequent Events - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions		1 Months Ended				3 Months Ended						6 Months Ended	9 Months Ended
	Oct. 28, 2024	Oct. 18, 2024	Dec. 31, 2023	Sep. 30, 2023	Jun. 30, 2023	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Oct. 07, 2024	Aug. 15, 2024	Aug. 12, 2024	Mar. 08, 2024	Oct. 12, 2023	Oct. 10, 2023	Jan. 31, 2023	Jan. 12, 2023
Subsequent Event [Line Items]
Warrants exercise price per share					$ 50.5					$ 50.5		$ 50.5							$ 18.7	$ 19.3
Warrants issued					301,886	7,141,572				301,886		301,886	7,141,572						427,807	100,000
Shares issued, price per share					$ 53					$ 53		$ 53
Gross proceeds from issue of shares and warrants							$ 5.5
Amended Warrants
Subsequent Event [Line Items]
Warrants exercise price per share								$ 11									$ 6
Class of Warrant or Right, Outstanding								641,582									2,291,445
Common Stock
Subsequent Event [Line Items]
Issuance of stock, net, shares				923,528		52,581	545,454	259,158	8,291	150,943	285,310
Warrants exercise price per share				$ 30.1					$ 30.1					$ 30.1
Common stock issued and sold					150,943
Common Stock | Private Placement
Subsequent Event [Line Items]
Warrants issued								545,454
2028 Convertible Notes
Subsequent Event [Line Items]
Principal amount																		$ 3.8
Sale Agreement
Subsequent Event [Line Items]
Proceeds from Sale of Equity						$ 0.4			$ 0.2				$ 3.2	$ 12.7
Sale of stock weighted average purchase price						$ 6.9			$ 21.86				$ 10.86	$ 45.45
Common stock issued and sold						52,581			8,292				311,739	293,603
Note Exchange Agreements | Common Stock
Subsequent Event [Line Items]
Issuance of stock, net, shares			62,500
Note Exchange Agreements | 2028 Convertible Notes
Subsequent Event [Line Items]
Principal amount			$ 23.9			$ 10.8							$ 10.8				$ 10.8
Note Exchange Agreements | Payment Priority Notes
Subsequent Event [Line Items]
Principal amount						$ 10.8							$ 10.8			$ 10.8
Securities Purchase Agreement
Subsequent Event [Line Items]
Warrants exercise price per share																					$ 82.2
Warrants issued					301,886					301,886		301,886									9,000	9,000
Shares issued, price per share								$ 11
Securities Purchase Agreement | Private Placement
Subsequent Event [Line Items]
Warrants exercise price per share								$ 11
Securities Purchase Agreement | Common Stock
Subsequent Event [Line Items]
Common stock issued and sold								545,454				150,943
Subsequent Event
Subsequent Event [Line Items]
Warrants exercise price per share															$ 6
Warrants issued															676,666
Gross proceeds from issue of shares and warrants	$ 3
Subsequent Event | Amended Warrants
Subsequent Event [Line Items]
Warrants exercise price per share	$ 3.9
Class of Warrant or Right, Outstanding		531,162
Subsequent Event | Common Stock | Private Placement
Subsequent Event [Line Items]
Warrants issued	745,342
Subsequent Event | Payment Priority Notes
Subsequent Event [Line Items]
Principal amount															$ 4
Subsequent Event | Sale Agreement
Subsequent Event [Line Items]
Issuance of stock, net, shares		99,672
Proceeds from Sale of Equity		$ 0.5
Sale of stock weighted average purchase price		$ 4.67
Subsequent Event | Note Exchange Agreements | 2028 Convertible Notes
Subsequent Event [Line Items]
Principal amount															10.8
Subsequent Event | Note Exchange Agreements | Payment Priority Notes
Subsequent Event [Line Items]
Principal amount															$ 10.8
Subsequent Event | Securities Purchase Agreement
Subsequent Event [Line Items]
Shares issued, price per share	$ 4.025
Subsequent Event | Securities Purchase Agreement | Private Placement
Subsequent Event [Line Items]
Warrants exercise price per share	$ 3.9
Subsequent Event | Securities Purchase Agreement | Common Stock
Subsequent Event [Line Items]
Common stock issued and sold	745,342