LivaNova (LIVN) 10-Q 29 Oct 20 2020 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2020	Oct. 27, 2020
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2020
Document Transition Report	false
Entity File Number	001-37599
Entity Registrant Name	LivaNova PLC
Entity Incorporation, State or Country Code	X0
Entity Tax Identification Number	98-1268150
Entity Address, Address Line One	20 Eastbourne Terrace
Entity Address, City or Town	London
Entity Address, Country	GB
Entity Address, Postal Zip Code	W2 6LG
Country Region	44
City Area Code	0
Local Phone Number	203 325-0660
Title of 12(b) Security	Ordinary Shares - £1.00 par value per share
Trading Symbol	LIVN
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding (in shares)		48,596,417
Amendment Flag	false
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q3
Entity Central Index Key	0001639691
Current Fiscal Year End Date	--12-31

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income (Loss) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Income Statement [Abstract]
Net sales	$ 240,083	$ 268,610	$ 664,686	$ 796,580
Costs and expenses:
Cost of sales - exclusive of amortization	86,467	86,128	212,152	245,324
Product remediation	1,133	3,076	6,868	11,136
Selling, general and administrative	99,199	123,015	317,424	375,932
Research and development	47,368	45,904	108,422	124,023
Merger and integration expenses	1,094	6,716	6,616	14,345
Restructuring expenses	(349)	698	2,025	4,563
Impairment of intangible assets	0	0	0	50,295
Amortization of intangibles	9,685	11,146	29,346	29,690
Litigation provision, net	2,994	(33,834)	3,970	(33,834)
Operating (loss) income from continuing operations	(7,508)	25,761	(22,137)	(24,894)
Interest income	47	151	482	624
Interest expense	(14,673)	(4,774)	(25,237)	(10,490)
Foreign exchange and other gains (losses)	3,420	327	507	(795)
(Loss) income from continuing operations before tax	(18,714)	21,465	(46,385)	(35,555)
Income tax (benefit) expense	(3,990)	(10,653)	17,581	(23,431)
Losses from equity method investments	(48)	0	(221)	0
Net (loss) income from continuing operations	(14,772)	32,118	(64,187)	(12,124)
Net (loss) income from discontinued operations, net of tax	0	0	(995)	178
Net (loss) income	$ (14,772)	$ 32,118	$ (65,182)	$ (11,946)
Basic (loss) income per share:
Continuing operations (in dollars per share)	$ (0.30)	$ 0.66	$ (1.32)	$ (0.25)
Discontinued operations (in dollars per share)	0	0	(0.02)	0
Earnings per share (in dollars per share)	(0.30)	0.66	(1.34)	(0.25)
Diluted (loss) income per share:
Continuing operations (in dollars per share)	(0.30)	0.66	(1.32)	(0.25)
Discontinued operations (in dollars per share)	0	0	(0.02)	0
Earnings per share (in dollars per share)	$ (0.30)	$ 0.66	$ (1.34)	$ (0.25)
Shares used in computing basic (loss) income per share (in shares)	48,652	48,395	48,582	48,329
Shares used in computing diluted (loss) income per share (in shares)	48,652	48,820	48,582	48,329

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Statement of Comprehensive Income [Abstract]
Net (loss) income	$ (14,772)	$ 32,118	$ (65,182)	$ (11,946)
Other comprehensive income (loss):
Net change in unrealized gain (loss) on derivatives	1,640	(870)	1,313	(665)
Tax effect	(393)	209	(314)	159
Net of tax	1,247	(661)	999	(506)
Foreign currency translation adjustment	23,457	(27,775)	8,008	(16,628)
Total other comprehensive income (loss)	24,704	(28,436)	9,007	(17,134)
Total comprehensive income (loss)	$ 9,932	$ 3,682	$ (56,175)	$ (29,080)

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Current Assets:
Cash and cash equivalents	$ 227,811	$ 61,137
Accounts receivable, net of allowance of $16,241 at September 30, 2020 and $13,105 at December 31, 2019	191,892	257,769
Inventories	178,091	164,154
Prepaid and refundable taxes	43,316	37,779
Prepaid expenses and other current assets	32,026	28,604
Total Current Assets	673,136	549,443
Property, plant and equipment, net	190,509	181,354
Goodwill	918,478	915,794
Intangible assets, net	583,818	607,546
Operating lease assets	52,834	54,372
Investments	30,358	27,256
Deferred tax assets	22,673	68,676
Other assets	49,942	7,356
Total Assets	2,521,748	2,411,797
Current Liabilities:
Current debt obligations	13,953	77,396
Accounts payable	71,596	85,892
Accrued liabilities and other	98,308	120,100
Current litigation provision liability	34,790	146,026
Taxes payable	10,118	12,719
Accrued employee compensation and related benefits	52,994	70,420
Total Current Liabilities	281,759	512,553
Long-term debt obligations	637,109	260,330
Contingent consideration	79,603	114,396
Litigation provision liability	11,510	24,378
Deferred tax liabilities	28,362	32,219
Long-term operating lease liabilities	43,124	46,027
Long-term employee compensation and related benefits	23,109	22,797
Long-term derivative liabilities	59,588	61
Other long-term liabilities	6,792	15,319
Total Liabilities	1,170,956	1,028,080
Commitments and contingencies (Note 10)
Stockholders’ Equity:
Ordinary Shares, £1.00 par value: unlimited shares authorized; 49,402,628 shares issued and 48,596,417 shares outstanding at September 30, 2020; 49,411,016 shares issued and 48,443,830 shares outstanding at December 31, 2019	76,338	76,257
Additional paid-in capital	1,758,468	1,734,870
Accumulated other comprehensive loss	(10,385)	(19,392)
Accumulated deficit	(472,576)	(406,755)
Treasury stock at cost, 806,211 ordinary shares at September 30, 2020; 967,186 ordinary shares at December 31, 2019	(1,053)	(1,263)
Total Stockholders’ Equity	1,350,792	1,383,717
Total Liabilities and Stockholders’ Equity	$ 2,521,748	$ 2,411,797

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) $ in Thousands	Sep. 30, 2020USD ($)shares	Sep. 30, 2020£ / shares	Dec. 31, 2019USD ($)shares	Dec. 31, 2019£ / shares
Statement of Financial Position [Abstract]
Allowance for doubtful accounts | $	$ 16,241		$ 13,105
Ordinary shares, par value (in pounds per share) | £ / shares		£ 1		£ 1
Ordinary shares issued (in shares)	49,402,628		49,411,016
Ordinary shares outstanding (in shares)	48,596,417		48,443,830
Treasury stock (in shares)	806,211		967,186

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Operating Activities:
Net (loss) income	$ (65,182)	$ (11,946)
Non-cash items included in net loss:
Deferred tax expense (benefit)	41,133	(26,422)
Remeasurement of contingent consideration to fair value	(31,176)	(2,425)
Amortization	29,346	29,690
Stock-based compensation	26,845	24,127
Depreciation	22,206	23,115
Remeasurement of derivative instruments	(17,654)	(2,948)
Amortization of operating lease assets	9,813	8,961
Impairment of intangible assets	0	50,295
Other	5,876	7,638
Changes in operating assets and liabilities:
Accounts receivable, net	65,401	5,433
Inventories	(12,141)	(18,181)
Other current and non-current assets	(15,360)	9,575
Accounts payable and accrued current and non-current liabilities	(49,547)	(28,964)
Taxes payable	(615)	(14,367)
Litigation provision liability	(124,158)	(140,823)
Restructuring reserve	(1,194)	(6,766)
Net cash used in operating activities	(116,407)	(94,008)
Investing Activities:
Purchases of property, plant and equipment	(28,445)	(16,801)
Purchase of investments	(3,175)	(287)
Loans to investees	(2,250)	0
Acquisitions, net of cash acquired	0	(10,750)
Purchases of intangible assets	0	(3,186)
Other	533	505
Net cash used in investing activities	(33,337)	(30,519)
Financing Activities:
Proceeds from long-term debt obligations	886,899	193,490
Repayment of long-term debt obligations	(481,360)	(12,330)
Proceeds from short term borrowings (maturities greater than 90 days)	46,717	0
Repayments of short term borrowings (maturities greater than 90 days)	(44,838)	0
Purchase of capped call	(43,096)	0
Debt issuance costs	(20,412)	(3,795)
Closing adjustment payment for sale of CRM business	(14,891)	0
Payment of contingent consideration	(8,860)	(17,989)
Shares repurchased from employees for minimum tax withholding	(5,277)	(6,183)
Proceeds from share issuances under ESPP	2,063	2,574
Change in short-term borrowing, net	(1,043)	(2,173)
Other	25	147
Net cash provided by financing activities	315,927	153,741
Effect of exchange rate changes on cash and cash equivalents	491	(1,105)
Net increase in cash and cash equivalents	166,674	28,109
Cash and cash equivalents at beginning of period	61,137	47,204
Cash and cash equivalents at end of period	$ 227,811	$ 75,313

Unaudited Condensed Consolidate

Unaudited Condensed Consolidated Financial Statements	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Unaudited Condensed Consolidated Financial Statements	Note 1. Unaudited Condensed Consolidated Financial Statements Basis of Presentation The accompanying condensed consolidated financial statements of LivaNova as of, and for the three and nine months ended September 30, 2020 and 2019, have been prepared in accordance with U.S. GAAP for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. The accompanying condensed consolidated balance sheet of LivaNova at December 31, 2019 has been derived from audited financial statements contained in our 2019 Form 10-K, but does not include all of the information and footnotes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments (consisting of only normal recurring adjustments) considered necessary for a fair statement of the operating results of LivaNova and its subsidiaries, for the three and nine months ended September 30, 2020, and are not necessarily indicative of the results that may be expected for the year ending December 31, 2020. The financial information presented herein should be read in conjunction with the audited consolidated financial statements and notes thereto accompanying our 2019 Form 10-K. Recent Developments Regarding COVID-19 Due to the COVID-19 pandemic (“COVID-19”), we have experienced and may continue to experience significant and unpredictable reductions in the demand for our products as healthcare customers have diverted medical resources and priorities towards the treatment of COVID-19. In addition, public health bodies have delayed elective procedures during the COVID-19 pandemic, which has negatively impacted the usage of our products, including the number of Neuromodulation procedures. Further, some people are avoiding seeking treatment for non-COVID-19 emergency procedures, which has also negatively impacted the demand for our products. We are seeing signs of stabilization in certain geographies as elective surgeries resume and expect this trend to continue on a global basis during the fourth quarter of 2020. We expect elective procedure recovery rates to vary by country, and to be impacted by COVID-19 case volumes, hospital occupancy and staffing levels, patient’s willingness to re-book previously deferred procedures, travel restrictions, transportation limitations, quarantine restrictions, economic uncertainty and potential COVID-19 resurgence. Reclassifications We have reclassified certain prior period amounts for comparative purposes. These reclassifications did not have a material effect on our financial condition, results of operations or cash flows. Significant Accounting Policies

Business Combinations

Business Combinations	9 Months Ended
	Sep. 30, 2020
Business Combinations [Abstract]
Business Combinations	Note 2. Business Combinations Miami Instruments On June 12, 2019, we acquired the minimally invasive cardiac surgery instruments business from Miami Instruments, LLC (“Miami Instruments”) for cash consideration of up to $17.0 million. The related operations have been integrated into our Cardiovascular segment as a part of our Heart Valves business. Cash of $10.8 million was paid at closing with up to $6.0 million in contingent consideration based on achieving certain milestones. The purchase price allocation for the Miami Instruments acquisition was finalized during the second quarter of 2020 and resulted in no measurement period adjustments. In connection with this acquisition, we recognized $14.7 million in developed technology and in-process research and development (“IPR&D”) intangible assets and $1.5 million in goodwill.

Discontinued Operations

Discontinued Operations	9 Months Ended
	Sep. 30, 2020
Discontinued Operations and Disposal Groups [Abstract]
Discontinued Operations	Note 3. Discontinued Operations On April 30, 2018, we completed the sale of our Cardiac Rhythm Management (“CRM”) business to MicroPort Cardiac Rhythm B.V. and MicroPort Scientific Corporation (“MicroPort”) for total cash proceeds of $195.9 million, less cash transferred of $9.2 million, subject to a closing working capital adjustment. In March 2020, we finalized the working capital adjustment and as a result, made a $16.4 million payment to MicroPort during the first quarter of 2020 and incurred an additional $1.0 million loss on sale, net of a $0.1 million tax benefit.

Restructuring

Restructuring	9 Months Ended
	Sep. 30, 2020
Restructuring and Related Activities [Abstract]
Restructuring	Note 4. Restructuring We initiate restructuring plans to leverage economies of scale, streamline distribution and logistics, and strengthen operational and administrative effectiveness in order to reduce overall costs. Costs associated with these plans were reported as restructuring expenses in the operating results of our condensed consolidated statements of income (loss). The following table provides a reconciliation of the beginning and ending balance of the accruals and other reserves recorded in connection with our restructuring plans included within accrued liabilities and other and other long-term liabilities on the condensed consolidated balance sheet (in thousands): Employee Severance and Other Termination Costs Other Total Balance at December 31, 2019 $ 4,097 $ 1,400 $ 5,497 Charges 2,025 — 2,025 Cash payments and other (4,880) (792) (5,672) Balance at September 30, 2020 $ 1,242 $ 608 $ 1,850 The following table presents restructuring expense by reportable segment (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Cardiovascular $ 9 $ 783 $ 1,265 $ 1,521 Neuromodulation 43 (171) 851 314 Other (401) 86 (91) 2,728 Total $ (349) $ 698 $ 2,025 $ 4,563

Product Remediation Liability

Product Remediation Liability	9 Months Ended
	Sep. 30, 2020
Product Remediation [Abstract]
Product Remediation Liability	Note 5. Product Remediation Liability On December 29, 2015, we received an FDA Warning Letter (the “Warning Letter”) alleging certain violations of FDA regulations applicable to medical device manufacturing at our Munich, Germany and Arvada, Colorado facilities. On October 13, 2016, the CDC and FDA separately released safety notifications regarding 3T Heater-Cooler devices in response to which we issued a Field Safety Notice Update for U.S. users of our 3T Heater-Cooler devices to proactively and voluntarily contact facilities to facilitate implementation of the CDC and FDA recommendations. At December 31, 2016, we recognized a liability for a product remediation plan related to our 3T Heater-Cooler device (“3T device”). The remediation plan consists primarily of a modification of the 3T device design to include internal sealing and the addition of a vacuum system to new and existing devices. These changes are intended to address regulatory actions and to reduce further the risk of possible dispersion of aerosols from 3T devices in the operating room. We concluded that it was probable that a liability had been incurred upon management’s approval of the plan and the commitments made by management to various regulatory authorities globally in November and December 2016, and furthermore, the cost associated with the plan was reasonably estimable. The deployment of this solution for commercially distributed devices has been dependent upon final validation and verification of the design changes and approval or clearance by regulatory authorities worldwide. It is reasonably possible that our estimate of the remediation liability could materially change in future periods due to the various significant assumptions involved such as customer behavior, market reaction and the timing of approvals or clearance by regulatory authorities worldwide. In April 2017, we obtained CE Mark in Europe for the design change, and in May 2017 we completed our first vacuum canister and internal sealing upgrade on a customer-owned device. In October 2018, the FDA concluded that we could commence the vacuum canister and internal sealing upgrade program in the U.S., and on February 25, 2020, LivaNova received clearance for K191402, a 510(k) for the 3T devices that addressed issues contained in the 2015 Warning Letter along with design changes that further mitigate the potential risk of aerosolization. Concurrent with this clearance, (1) 3T devices manufactured in accordance with K191402 will not be subjected to the import alert previously issued by the FDA and (2) LivaNova initiated a correction to distribute the updated Operating Instructions cleared under K191402. We continue to implement the vacuum canister and internal sealing upgrade program in as many countries as possible until all devices are upgraded. As a second part of the remediation plan, we continue to offer a no-charge deep disinfection service (deep cleaning service) for 3T device users as we receive the required regulatory approvals. The deep disinfection service was rolled out in Europe in the second half of 2015, and in April 2018, the FDA agreed to allow us to move forward with the deep cleaning service in the U.S., thereby adding to the growing list of countries around the world in which we offer this service. Finally, we continue to offer the loaner program for 3T devices, initiated in the fourth quarter of 2016, to provide existing 3T device users with a new loaner 3T device at no charge pending regulatory approval and implementation of the vacuum system addition and deep disinfection service worldwide. The following table provides a reconciliation of the beginning and ending balance of the product remediation liability included within accrued liabilities and other on the condensed consolidated balance sheet (in thousands): Balance at December 31, 2019 $ 3,251 Adjustments 2,301 Remediation activity (3,982) Effect of changes in foreign currency exchange rates 145 Balance at September 30, 2020 $ 1,715 We recognized product remediation expenses of $1.1 million and $3.1 million during the three months ended September 30, 2020 and 2019, respectively, and $6.9 million and $11.1 million during the nine months ended September 30, 2020 and 2019, respectively. Product remediation expenses include internal labor costs, costs to remediate certain inspectional observations made by the FDA at our Munich facility and costs associated with the incorporation of the modification of the 3T device design into the next generation 3T device. These costs and related legal costs are expensed as incurred and are not included within the product remediation liability presented above. At September 30, 2020, our balance sheet includes a $46.3 million provision related to litigation involving our 3T device. For further information, please refer to “Note 10. Commitments and Contingencies.”

Investments

Investments	9 Months Ended
	Sep. 30, 2020
Investments [Abstract]
Investments	Note 6. Investments The following table details the carrying value of our investments in equity securities of non-consolidated affiliates without readily determinable fair values for which we do not exert significant influence over the investee. These equity investments are reported at cost minus impairment, if any, plus or minus changes resulting from observable price changes in orderly transactions for the identical or similar investment of the same issuer. The below equity investments are included in investments on the condensed consolidated balance sheets (in thousands): Equity Investments Without Readily Determinable Fair Values September 30, 2020 December 31, 2019 Respicardia Inc. (1) $ 17,706 $ 17,706 ALung Technologies, Inc. (2) 3,000 — Ceribell, Inc. 3,000 3,000 ShiraTronics, Inc. 2,045 2,045 MD Start II 1,169 1,121 Rainbow Medical Ltd. 1,145 1,099 Highlife S.A.S. 1,109 1,064 Other 770 770 29,944 26,805 Equity method investment 414 451 $ 30,358 $ 27,256 (1) Respicardia Inc. (“Respicardia”) is a privately funded U.S. company developing an implantable device designed to restore a more natural breathing pattern during sleep in patients with central sleep apnea by transvenously stimulating the phrenic nerve. We have a loan outstanding to Respicardia, with a carrying amount of $0.8 million and $0.6 million as of September 30, 2020 and December 31, 2019, respectively, which is included in prepaid expenses and other current assets on the condensed consolidated balance sheet. (2) During the first quarter of 2020, we invested in ALung Technologies, Inc. (“ALung”). ALung is a privately held medical device company focused on creating advanced medical devices for treating respiratory failure. ALung’s Hemolung Respiratory Assist System is a dialysis-like alternative or supplement to mechanical ventilation which removes carbon dioxide directly from the blood in patients with acute respiratory failure. During the second quarter of 2020, we provided a convertible loan to ALung for $2.0 million, due July 10, 2021. As of September 30, 2020, the carrying amount of the loan was $2.0 million, which is included in prepaid expenses and other current assets on the condensed consolidated balance sheet.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2020
Fair Value Disclosures [Abstract]
Fair Value Measurements	Note 7. Fair Value Measurements We review the fair value hierarchy classification on a quarterly basis. Changes in the ability to observe valuation inputs may result in a reclassification of levels for certain securities within the fair value hierarchy. There were no transfers between Level 1, Level 2, or Level 3 during the nine months ended September 30, 2020 and 2019. Assets and Liabilities Measured at Fair Value on a Recurring Basis The following tables provide information by level for assets and liabilities that are measured at fair value on a recurring basis (in thousands): Fair Value as of September 30, 2020 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets: Derivative assets - designated as cash flow hedges (foreign currency exchange rate “FX”) $ 1,787 $ — $ 1,787 $ — Derivative assets - freestanding instruments (FX) 4,052 — 4,052 — Derivative assets - capped call derivatives 38,999 — — 38,999 Convertible notes receivable 2,301 — — 2,301 $ 47,139 $ — $ 5,839 $ 41,300 Liabilities: Derivative liabilities - freestanding instruments (interest rate swaps) $ 139 $ — $ 139 $ — Derivative liabilities - freestanding instruments (FX) 85 — 85 — Derivative liabilities - embedded exchange feature 59,398 — — 59,398 Derivative liabilities - other 1,350 — — 1,350 Contingent consideration arrangements 96,174 — — 96,174 $ 157,146 $ — $ 224 $ 156,922 Fair Value as of December 31, 2019 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets: Derivative assets - designated as cash flow hedges (FX) $ 535 $ — $ 535 $ — Derivative assets - freestanding instruments (FX) 26 — 26 — $ 561 $ — $ 561 $ — Liabilities: Derivative liabilities - designated as cash flow hedges (FX) $ 169 $ — $ 169 $ — Derivative liabilities - designated as cash flow hedges (interest rate swaps) 374 — 374 — Derivative liabilities - freestanding instruments (FX) 3,137 — 3,137 — Contingent consideration arrangements 137,349 — — 137,349 $ 141,029 $ — $ 3,680 $ 137,349 The following table provides a reconciliation of the beginning and ending balances of our recurring fair value measurements, using significant unobservable inputs (Level 3) (in thousands): Capped Call Derivative Asset Embedded Exchange Feature Derivative Liability Other Derivative Liabilities Contingent Consideration Liability Arrangements Convertible Notes Receivable As of December 31, 2019 $ — $ — $ — $ 137,349 $ — Additions 43,096 74,951 — — 2,267 Payments (1) — — — (9,868) — Changes in fair value (2) (3) (4) (4,097) (15,553) 1,350 (31,176) 34 Effect of changes in foreign currency exchange rates — — — (131) — Total at September 30, 2020 38,999 59,398 1,350 96,174 2,301 Less current portion at September 30, 2020 — — 1,160 16,571 2,044 Long-term portion at September 30, 2020 $ 38,999 $ 59,398 $ 190 $ 79,603 $ 257 (1) During the nine months ended September 30, 2020, we paid $8.8 million under the contingent consideration arrangement for the acquisition of CardiacAssist, Inc., doing business as TandemLife (“TandemLife”). Additionally, we made final payments under contingent consideration arrangements resulting from the acquisitions of two distributors. (2) The contingent consideration change in fair value during the nine months ended September 30, 2020 is primarily due to a one-year delay in the projected achievement of a certain regulatory milestone and timing of sales-based earnout payments for ImThera Medical Inc. (“ImThera”), and the impact of an increase in discount rates utilized in the valuation of contingent consideration. Refer to the tables below for further information regarding the fair value measurements of contingent consideration. (3) During the nine months ended September 30, 2020, the contingent consideration change in fair value resulted in a decrease of $19.2 million and $12.0 million recorded to cost of sales - exclusive of amortization and research and development, respectively. (4) Changes in the fair value of the embedded exchange feature derivative and capped call derivatives are recognized in foreign exchange and other gains (losses) in the condensed consolidated statements of income (loss). Embedded Exchange Feature and Capped Call Derivatives In June 2020, the Company issued $287.5 million in cash exchangeable senior notes and entered into related capped call transactions. The cash exchangeable senior notes include an embedded exchange feature that is bifurcated from the cash exchangeable senior notes. Please refer to “Note 8. Financing Arrangements” for further details. The embedded exchange feature derivative is measured at fair value using a binomial lattice model and discounted cash flows that utilize observable and unobservable market data. The capped call derivative is measured at fair value using the Black-Scholes model utilizing observable and unobservable market data, including stock price, remaining contractual term, expected volatility, risk-free interest rate and expected dividend yield, as applicable. The embedded exchange feature and capped call derivatives are classified as Level 3 as the Company uses historical volatility and implied volatility from options traded to determine expected stock price volatility which is an unobservable input that is significant to the valuation. In general, an increase in our stock price or stock price volatility would increase the fair value of the embedded exchange feature and capped call derivatives which would result in an increase in expense. As time to the expiration of the derivatives decreases with passage of time, the fair value of the derivatives would decrease. The future impact on net income depends on how significant inputs such as stock price, stock price volatility and time to the expiration of the derivatives change in relation to other inputs. The stock price volatility as of September 30, 2020 was 37%. As of September 30, 2020, a 10% lower volatility, holding other inputs constant, would result in approximate fair value for the embedded exchange feature derivative of $42.4 million and a 10% higher volatility, holding other inputs constant, would result in approximate fair value of $76.4 million. As of September 30, 2020, a 10% lower volatility, holding other inputs constant would result in approximate fair value for the capped call derivatives of $29.3 million and a 10% higher volatility, holding other inputs constant, would result in approximate fair value of $42.3 million. Contingent Consideration Arrangements The following table provides the fair value of our Level 3 contingent consideration arrangements by acquisition (in thousands): September 30, 2020 December 31, 2019 ImThera $ 79,603 $ 113,503 TandemLife 11,672 17,311 Miami Instruments 4,899 5,338 Drilltex — 294 Other — 903 $ 96,174 $ 137,349 The ImThera business combination involved contingent consideration arrangements composed of potential cash payments upon the achievement of a certain regulatory milestone and a sales-based earnout associated with sales of products. The sales-based earnout is valued using projected sales from our internal strategic plan. Both arrangements are Level 3 fair value measurements and include the following significant unobservable inputs as of September 30, 2020: ImThera Acquisition Valuation Technique Unobservable Input Ranges Regulatory milestone-based payment Discounted cash flow Discount rate 8.3% Probability of payment 85% Projected payment year 2024 Sales-based earnout Monte Carlo simulation Risk-adjusted discount rate 12.2 % - 12.5% Credit risk discount rate 8.5 % - 9.2% Revenue volatility 32.5% Probability of payment 85% Projected years of earnout 2025 - 2028 The TandemLife business combination involved a contingent consideration arrangement composed of potential cash payments upon the achievement of certain regulatory milestones. The arrangement is a Level 3 fair value measurement and includes the following significant unobservable inputs as of September 30, 2020: TandemLife Acquisition Valuation Technique Unobservable Input Ranges Regulatory milestone-based payment Discounted cash flow Discount rate 7.6 % - 7.7% Probability of payments 70 % - 100% Projected payment years 2020 - 2021 The Miami Instruments business combination involved a contingent consideration arrangement composed of potential cash payments upon the achievement of certain regulatory milestones. The arrangement is a Level 3 fair value measurement and includes the following significant unobservable inputs as of September 30, 2020: Miami Instruments Valuation Technique Unobservable Input Ranges Regulatory milestone-based payments Discounted cash flow Discount rate 7.6 % - 7.7% Probability of payments 80 % - 95% Projected payment years 2020 - 2021

Financing Arrangements

Financing Arrangements	9 Months Ended
	Sep. 30, 2020
Debt Disclosure [Abstract]
Financing Arrangements	Note 8. Financing Arrangements The carrying amount of our long-term debt as of September 30, 2020 and December 31, 2019 was as follows (in thousands, except interest rates): September 30, 2020 December 31, 2019 Maturity Interest Rate 2020 Senior Secured Term Loan $ 422,960 $ — June 2025 LIBOR (1% Floor) + 6.50% 2020 Cash Exchangeable Senior Notes 208,954 — December 2025 3.00% Bank of America Merrill Lynch Banco Múltiplo S.A. 6,000 8,422 July 2021 5.61% Mediocredito Italiano 5,835 6,222 December 2023 0.50 % - 2.77% Bank of America, U.S. 2,011 2,004 January 2021 2.08% 2019 Debt Facility — 184,275 2017 European Investment Bank — 103,570 2014 European Investment Bank — 28,053 Other 1,041 965 Total long-term facilities 646,801 333,511 Less current portion of long-term debt 9,692 73,181 Total long-term debt $ 637,109 $ 260,330 Revolving Credit The outstanding principal amount of our short-term unsecured revolving credit agreements and other agreements with various banks was $4.3 million and $4.2 million, at September 30, 2020 and December 31, 2019, respectively, with interest rates ranging from 3.21% to 7.20% and loan terms ranging from overnight to 10 months, as of September 30, 2020. 2020 Senior Secured Term Loan On June 10, 2020, we entered into a $450.0 million five-year senior secured term loan (the “Term Loan”) through our wholly owned subsidiary LivaNova USA Inc., with funds managed by affiliates of Ares Management Corporation, as administrative agent and collateral agent, resulting in cash proceeds of approximately $421.7 million, net of discounts and issuance costs. The obligations under the Term Loan are guaranteed on a senior secured basis by each of LivaNova’s existing and future wholly owned material subsidiaries, and are secured by a perfected first priority security interest in substantially all tangible and intangible assets of LivaNova and certain U.S. and UK subsidiaries of LivaNova, subject in each case to certain exceptions contained in the Term Loan. Borrowings under the Term Loan bear interest at a variable annual rate equal to the three-month LIBOR rate (subject to a 1% floor), plus an applicable margin of 6.5% per annum. The effective interest rate of the Term Loan at September 30, 2020 was 9.0%. The Term Loan will mature on June 30, 2025 and includes certain affirmative, negative and financial covenants. The financial covenants under the Term Loan state (i) the net revenue of LivaNova PLC, LivaNova USA, Inc. and any restricted subsidiaries on a consolidated basis shall not be lower than $700 million for each trailing 12 month period, such threshold to decrease pro rata (not below $550 million) upon prepayments of the Term Loan made by LivaNova USA, Inc. out of the proceeds of certain asset sales, and (ii) the total secured leverage ratio (as defined in the debt agreement) for LivaNova PLC, LivaNova USA, Inc. and any restricted subsidiaries on a consolidated basis shall not be greater than the applicable ratio set forth below: Test Period Total Secured Leverage Ratio 4 Quarters ending June 30, 2020 through each fiscal quarter thereafter until (and including) the fiscal quarter ending June 30, 2021 5.625 : 1.00 4 Quarters ending September 30, 2021 and ending each fiscal quarter thereafter 4.5 : 1.00 Debt discounts and issuance costs related to the Term Loan were approximately $28.3 million and included various legal, bank and accounting fees. Amortization of debt discount and issuance costs was $1.1 million and $1.3 million for the three and nine months ended September 30, 2020, respectively, and was included in interest expense on the condensed consolidated statement of income (loss). 2020 Cash Exchangeable Senior Notes On June 17, 2020, our wholly-owned subsidiary, LivaNova USA, Inc., issued $287.5 million aggregate principal amount of 3.00% cash exchangeable senior notes (the “Notes”) by private placement to qualified institutional buyers pursuant to Rule 144A under the Securities Act of 1933, as amended. The sale of the Notes resulted in approximately $278.0 million in net proceeds to the Company after deducting issuance costs. Interest is payable semiannually in arrears on June 15 and December 15 of each year, beginning on December 15, 2020. The effective interest rate of the Notes at September 30, 2020 was 9.9%. The Notes mature on December 15, 2025 unless earlier exchanged, repurchased, or redeemed. Debt discounts and issuance costs related to the Notes were approximately $82.0 million and included $75.0 million of discount attributable to the embedded exchange feature, discussed below, and $7.0 million of allocated issuance costs to the Notes related to legal, bank and accounting fees. Amortization of debt discount and issuance costs was $3.0 million and $3.4 million for the three and nine months ended September 30, 2020 and is included in interest expense on the condensed consolidated statement of income (loss). The Notes are exchangeable at the option of the holders only under certain circumstances and solely into cash in an amount based on the trading prices of LivaNova’s ordinary shares during a related observation period. The Notes are not exchangeable into ordinary shares of LivaNova or any other security under any circumstances. The initial exchange rate for the Notes is 16.3980 ordinary shares per $1,000 principal amount of Notes (equivalent to an initial exchange price of approximately $60.98 per share). The exchange rate is subject to adjustment in certain circumstances, as set forth in the indenture governing the Notes. The Company may redeem the Notes at its option, on or after June 20, 2023, in whole or in part, if the last reported sale price per ordinary share has been at least 130% of the exchange price then in effect for at least 20 trading days (whether or not consecutive), including the trading day immediately preceding the date on which the Company provides notice of redemption, during any 30 consecutive trading day period ending on, and including, the trading day immediately preceding the date on which the Company provides notice of redemption, at a redemption price equal to 100% of the principal amount of the Notes to be redeemed, plus accrued and unpaid interest to, but excluding, the redemption date. Additionally, the Company may redeem the Notes at its option, prior to December 15, 2025, in whole but not in part, in connection with certain tax-related events. Embedded Exchange Feature The embedded exchange feature of the Notes requires bifurcation from the Notes and is accounted for as a derivative liability. The fair value of the Notes’ embedded exchange feature derivative at the time of issuance was $75.0 million and was recorded as debt discount on the Notes. This discount is amortized as interest expense using the effective interest method over the term of the Notes. The Notes’ embedded exchange feature derivative is carried on the condensed consolidated balance sheets at its estimated fair value and is adjusted at the end of each reporting period, with unrealized gain or loss reflected in the consolidated statements of income (loss). The fair value of the embedded exchange feature derivative liability was $59.4 million as of September 30, 2020. Capped Call Transactions In connection with the pricing of the Notes, the Company entered into privately negotiated capped call transactions with certain of the initial purchasers of the Notes or their respective affiliates. The capped call transactions cover, subject to anti-dilution adjustments substantially similar to those applicable to the Notes, the number of LivaNova’s ordinary shares underlying the Notes and are expected generally to offset any cash payments the Company is required to make upon exchange of the Notes in excess of the principal amount thereof in the event that the market value per ordinary share, as measured under the capped call transactions, is greater than the strike price of the capped call transactions, with such offset being subject to an initial cap price of $100.00 per share. The aggregate cost of the capped calls derivative assets was $43.1 million. The capped call transactions expire on December 15, 2025 and must be settled in cash. The capped calls are carried on the condensed consolidated balance sheets as a derivative asset at their estimated fair value and are adjusted at the end of each reporting period, with unrealized gain or loss reflected in the condensed consolidated statement of income (loss). The fair value of capped call derivative assets was $39.0 million as of September 30, 2020. The current and non-current classification is evaluated at each balance sheet date and may change depending on whether any exchange conditions are met. As of September 30, 2020, no exchange conditions have been met and the Notes, embedded exchange feature derivative liability, and the capped call derivative assets are classified as non-current. Please refer to “Note 7. Fair Value Measurements” for details on the valuation of the embedded exchange feature derivative liability and capped call derivative assets. Extinguishment of Debt The Company used the net proceeds from the Term Loan, together with a portion of the net proceeds of the Notes, after fees, discounts, commissions and other expenses, to repay outstanding indebtedness under the Company’s 2017 European Investment Bank loan, 2014 European Investment Bank loan, Banca Nazionale del Lavoro S.p.A loan, and 2019 Debt Facility and related expenses. The Company repaid approximately $528.0 million in aggregate outstanding principal, accrued interest and associated fees, including breakage fees and legal fees. The Company recognized a loss on debt extinguishment of $1.4 million during the nine months ended September 30, 2020. The loss on debt extinguishment was recognized in foreign exchange and other losses in the condensed consolidated statements of income (loss). The remainder of the proceeds from the concurrent financing transactions were used to pay the cost of capped call transactions and for general corporate purposes.

Derivatives and Risk Management

Derivatives and Risk Management	9 Months Ended
	Sep. 30, 2020
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivatives and Risk Management	Note 9. Derivatives and Risk Management Due to the global nature of our operations, we are exposed to foreign currency exchange rate fluctuations. We enter into FX derivative contracts to reduce the impact of foreign currency exchange rate fluctuations on earnings and cash flow. We are also exposed to equity price risk in connection with our Notes, including exchange and settlement provisions based on the price of our ordinary shares at exchange or maturity of the Notes. In addition, the capped call transactions associated with the Notes also include settlement provisions that are based on the price of our ordinary shares, subject to a capped price per share. We measure all outstanding derivatives each period end at fair value and report the fair value as either financial assets or liabilities on the condensed consolidated balance sheets. We do not enter into derivative contracts for speculative purposes. At inception of the contract, the derivative is designated as either a freestanding derivative or a hedge. Derivatives that are not designated as hedging instruments are referred to as freestanding derivatives with changes in fair value included in earnings. If the derivative qualifies for hedge accounting, changes in the fair value of the derivative will be recorded in accumulated other comprehensive income (“AOCI”) until the hedged item is recognized in earnings upon settlement/termination. FX derivative gains and losses in AOCI are reclassified to our condensed consolidated statements of income (loss) as shown in the tables below. We evaluate hedge effectiveness at inception. Cash flows from derivative contracts are reported as operating activities on our condensed consolidated statements of cash flows. Freestanding FX Derivative Contracts The gross notional amount of FX derivative contracts not designated as hedging instruments outstanding at September 30, 2020 and December 31, 2019 was $332.2 million and $338.0 million, respectively. These derivative contracts are designed to offset the FX effects in earnings of various intercompany loans and trade receivables. We recorded net (losses) gains for these freestanding derivatives of $(11.7) million and $3.1 million for the three months ended September 30, 2020 and 2019, respectively, and $(4.8) million and $6.8 million for the nine months ended September 30, 2020 and 2019, respectively. These (losses) and gains are included in foreign exchange and other gains (losses) on our condensed consolidated statement of income (loss). Counterparty Credit Risk We are exposed to credit risk in the event of non-performance by the counterparties to our derivatives at maturity. The two counterparties to the capped call transactions are financial institutions. To limit our credit risk, we selected financial institutions with a minimum long-term investment grade credit rating. Our exposure to the credit risk of the counterparties is not secured by any collateral. If a counterparty becomes subject to insolvency proceedings, we will become an unsecured creditor in those proceedings, with a claim equal to our exposure at that time under the capped call transactions with that counterparty. To manage credit risk with respect to our other derivatives, the Company selects and periodically reviews counterparties based on credit ratings, limits its exposure with respect to each counterparty, and monitors the market positions. However, if one or more of these counterparties were in a liability position to the Company and were unable to meet their obligations, any transactions with the counterparty could be subject to early termination, which could result in substantial losses for the Company. Cash Flow Hedges The gross notional amounts of open derivative contracts designated as cash flow hedges at September 30, 2020 and December 31, 2019 were as follows (in thousands): Description of Derivative Contract September 30, 2020 December 31, 2019 FX derivative contracts to be exchanged for British Pounds $ 7,610 $ 10,128 FX derivative contracts to be exchanged for Japanese Yen 16,023 25,342 FX derivative contracts to be exchanged for Euros 36,553 48,838 Interest rate swap contracts (1) — 22,442 $ 60,186 $ 106,750 (1) Interest rate swap contracts were de-designated upon the repayment of the 2014 European Investment Bank loan. Refer to “Note 8. Financing Arrangements.” After-tax net loss associated with derivatives designated as cash flow hedges recorded in the ending balance of AOCI and the amount expected to be reclassified to earnings in the next twelve months are as follows (in thousands): Description of Derivative Contract After-Tax Net Gain in AOCI as of September 30, 2020 After-Tax Net Gain in AOCI as of Amount Expected to be Reclassified to Earnings in Next 12 Months FX derivative contracts $ 1,512 $ 1,512 Pre-tax gains (losses) for derivative contracts designated as cash flow hedges recognized in other comprehensive income (loss) (“OCI”) and the amount reclassified to earnings from AOCI were as follows (in thousands): Three Months Ended September 30, 2020 2019 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss Gains Recognized in OCI (Losses) Gains Reclassified from AOCI to Earnings Losses Recognized in OCI Gains (Losses) Reclassified from AOCI to Earnings FX derivative contracts Foreign exchange and other gains (losses) $ 1,482 $ (692) $ (689) $ 963 FX derivative contracts SG&A — 534 — (742) Interest rate swap contracts Interest expense — — — (40) $ 1,482 $ (158) $ (689) $ 181 Nine Months Ended September 30, 2020 2019 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss Gains Recognized in OCI (Losses) Gains Reclassified from AOCI to Earnings Gains Recognized in OCI Gains (Losses) Reclassified from AOCI to Earnings FX derivative contracts Foreign exchange and other gains (losses) $ 632 $ (777) $ 933 $ 3,094 FX derivative contracts SG&A — 209 — (1,470) Interest rate swap contracts Interest expense — (113) — (26) $ 632 $ (681) $ 933 $ 1,598 We offset fair value amounts associated with our derivative instruments on our condensed consolidated balance sheets that are executed with the same counterparty under master netting arrangements. Our netting arrangements include a right to set off or net together purchases and sales of similar products in the settlement process. The following tables present the fair value and the location of derivative contracts reported on the condensed consolidated balance sheets (in thousands): September 30, 2020 Asset Derivatives Liability Derivatives Derivatives Designated as Hedging Instruments Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) FX derivative contracts Prepaid expenses and other current assets $ 1,775 FX derivative contracts Accrued liabilities 12 Total derivatives designated as hedging instruments 1,787 Derivatives Not Designated as Hedging Instruments Interest rate swap contracts Accrued liabilities $ 139 FX derivative contracts Prepaid expenses and other current assets 4,052 Accrued liabilities 51 FX derivative contracts Prepaid expense and other current assets 34 Capped call derivatives Other assets 38,999 Embedded exchange feature Long-term derivative liability 59,398 Other derivatives Accrued liabilities 1,160 Other derivatives Long-term derivative liability 190 Total derivatives not designated as hedging instruments 43,051 60,972 Total derivatives $ 44,838 $ 60,972 December 31, 2019 Asset Derivatives Liability Derivatives Derivatives Designated as Hedging Instruments Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) Interest rate swap contracts Accrued liabilities $ 313 Interest rate swap contracts Long-term derivative liability 61 FX derivative contracts Prepaid expenses and other current assets $ 148 Accrued liabilities 169 FX derivative contracts Accrued liabilities 387 Total derivatives designated as hedging instruments 535 543 Derivatives Not Designated as Hedging Instruments FX derivative contracts Accrued liabilities 26 Accrued liabilities 3,104 FX derivative contracts Prepaid expenses and other current assets 33 Total derivatives not designated as hedging instruments 26 3,137 Total derivatives $ 561 $ 3,680 (1) For the classification of inputs used to evaluate the fair value of our derivatives, refer to “Note 7. Fair Value Measurements.”

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2020
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Note 10. Commitments and Contingencies FDA Warning Letter On December 29, 2015, the FDA issued a Warning Letter alleging certain violations of FDA regulations applicable to medical device manufacturers at our Munich, Germany and Arvada, Colorado facilities. The FDA inspected the Munich facility from August 24, 2015 to August 27, 2015 and the Arvada facility from August 24, 2015 to September 1, 2015. On August 27, 2015, the FDA issued a Form 483 identifying two observed non-conformities with certain regulatory requirements at the Munich facility. We did not receive a Form 483 in connection with the FDA’s inspection of the Arvada facility. Following the receipt of the Form 483, we provided written responses to the FDA describing corrective and preventive actions that were underway or to be taken to address the FDA’s observations at the Munich facility. The Warning Letter responded in part to our responses and identified other alleged violations related to the manufacture of our 3T Heater-Cooler device that were not previously included in the Form 483. The Warning Letter further stated that our 3T devices and other devices we manufactured at our Munich facility were subject to refusal of admission into the U.S. until resolution of the issues set forth by the FDA in the Warning Letter. The FDA had informed us that the import alert was limited to the 3T devices, but that the agency reserved the right to expand the scope of the import alert if future circumstances warranted such action. The Warning Letter did not request that existing users cease using the 3T device, and manufacturing and shipment of all of our products other than the 3T device were unaffected by the import limitation. To help clarify these issues for current customers, we issued an informational Customer Letter in January 2016 and that same month agreed with the FDA on a process for shipping 3T devices to existing U.S. users pursuant to a certificate of medical necessity program. Finally, the Warning Letter stated that premarket approval applications for Class III devices to which certain Quality System regulation deviations identified in the Warning Letter were reasonably related would not be approved until the violations had been corrected; however, this restriction applied only to the Munich and Arvada facilities, which do not manufacture or design devices subject to Class III premarket approval. On February 25, 2020, LivaNova received clearance for K191402, a 510(k) for the 3T devices that addressed issues contained in the 2015 Warning Letter along with design changes that further mitigate the potential risk of aerosolization. Concurrent with this clearance, (1) 3T devices manufactured in accordance with K191402 will not be subjected to the import alert and (2) LivaNova initiated a correction to distribute the updated Operating Instructions cleared under K191402. We continue to work diligently to remediate the FDA’s inspectional observations for the Munich facility, as well as the additional issues identified in the Warning Letter. We take these matters seriously and intend to respond timely and fully to the FDA’s requests. CDC and FDA Safety Communications and Company Field Safety Notice On October 13, 2016, the CDC and the FDA separately released safety notifications regarding the 3T devices. The CDC’s Morbidity and Mortality Weekly Report (“MMWR”) and Health Advisory Notice (“HAN”) reported that tests conducted by the CDC and its affiliates indicate that there appears to be genetic similarity between both patient and 3T device strains of the non-tuberculous mycobacterium (“NTM”) bacteria M. chimaera isolated in hospitals in Iowa and Pennsylvania. Citing the geographic separation between the two hospitals referenced in the investigation, the report asserts that 3T devices manufactured prior to August 18, 2014 could have been contaminated during the manufacturing process. The CDC’s HAN and FDA’s Safety Communication, issued contemporaneously with the MMWR report, each assess certain risks associated with 3T devices and provide guidance for providers and patients. The CDC notification states that the decision to use the 3T device during a surgical operation is to be taken by the surgeon based on a risk approach and on patient need. Both the CDC’s and FDA’s communications confirm that 3T devices are critical medical devices and enable doctors to perform life-saving cardiac surgery procedures. Also on October 13, 2016, concurrent with the CDC’s HAN and FDA’s Safety Communication, we issued a Field Safety Notice Update for U.S. users of 3T devices to proactively and voluntarily contact facilities to aid in implementation of the CDC and FDA recommendations. In the fourth quarter of 2016, we initiated a program to provide existing 3T device users with a new loaner 3T device at no charge pending regulatory approval and implementation of additional risk mitigation strategies worldwide, including a vacuum canister and internal sealing upgrade program and a deep disinfection service. This loaner program is available on a global basis. We anticipate that this program will continue until we are able to address customer needs through a broader solution that includes implementation of the risk mitigation strategies described above. We are currently implementing the vacuum and sealing upgrade program in as many countries as possible until all devices are upgraded. On October 11, 2018, after review of information provided by us, the FDA concluded that we could commence the vacuum and sealing upgrade program in the U.S., and on February 25, 2020, LivaNova received clearance for K191402, a 510(k) for the 3T devices that addressed issues contained in the 2015 Warning Letter along with design changes that further mitigate the potential risk of aerosolization. Furthermore, we continue to offer a no-charge deep disinfection service (deep cleaning service) for 3T device users as we receive the required regulatory approvals. The deep disinfection service was rolled out in Europe in the second half of 2015, and on April 12, 2018, the FDA agreed to allow us to move forward with the deep cleaning service in the U.S. thereby adding to the growing list of countries around the world in which we offer this service. On December 31, 2016, we recognized a liability for our product remediation plan related to our 3T device. We concluded that it was probable that a liability had been incurred upon management’s approval of the plan and the commitments made by management to various regulatory authorities globally in November and December 2016, and furthermore, the cost associated with the plan was reasonably estimable. At September 30, 2020, the product remediation liability was $1.7 million. Refer to “Note 5. Product Remediation Liability” for additional information. Litigation Product Liability The Company is currently involved in litigation involving our 3T device. The litigation includes a class action complaint in the U.S. District Court for the Middle District of Pennsylvania, federal multi-district litigation in the U.S. District Court for the Middle District of Pennsylvania, various U.S. state court cases and cases in jurisdictions outside the U.S. The class action, filed in February 2016, consists of all Pennsylvania residents who underwent open heart surgery at WellSpan York Hospital and Penn State Milton S. Hershey Medical Center between 2011 and 2015 and who currently are asymptomatic for NTM infection. Members of the class seek declaratory relief that the 3T devices are defective and unsafe for intended uses, medical monitoring, damages, and attorneys’ fees. On March 29, 2019, we announced a settlement framework that provides for a comprehensive resolution of the personal injury cases pending in the multi-district litigation in U.S. federal court, the related class action pending in federal court, as well as certain cases in state courts across the United States. The agreement, which makes no admission of liability, is subject to certain conditions, including acceptance of the settlement by individual claimants and provides for a total payment of up to $225 million to resolve the claims covered by the settlement. Per the agreed-upon terms, the first payment of $135 million was paid into a qualified settlement fund in July 2019 and the second payment of $90 million was paid in January 2020. Cases covered by the settlement are being dismissed as amounts are disbursed to individual plaintiffs from the qualified settlement fund. Cases in state courts in the U.S. and in jurisdictions outside the U.S. continue to progress. As of October 29, 2020, including the cases encompassed in the settlement framework described above that have not yet been dismissed, we are aware of approximately 85 filed and unfiled claims worldwide, with the majority of the claims in various federal or state courts throughout the United States. This includes cases that have settled but have not yet been dismissed. The complaints generally seek damages and other relief based on theories of strict liability, negligence, breach of express and implied warranties, failure to warn, design and manufacturing defect, fraudulent and negligent misrepresentation or concealment, unjust enrichment, and violations of various state consumer protection statutes. At September 30, 2020, the provision for these matters was $46.3 million. While the amount accrued represents our best estimate, the actual liability for resolution of these matters may vary from our estimate. The changes in the litigation provision liability during the nine months ended September 30, 2020 are as follows (in thousands): Litigation Provision Liability Total litigation provision liability at December 31, 2019 $ 170,404 Payments (128,128) Adjustments 3,970 FX and other 54 Total litigation provision liability at September 30, 2020 46,300 Less current portion of litigation liability at September 30, 2020 34,790 Long-term portion of litigation provision liability at September 30, 2020 $ 11,510 Environmental Liability Our subsidiary, Sorin S.p.A. (“Sorin”) was created as a result of a spin-off (the “Sorin spin-off”) from SNIA S.p.A. (“SNIA”) in January 2004. SNIA subsequently became insolvent and the Italian Ministry of the Environment and the Protection of Land and Sea (the “Italian Ministry of the Environment”), sought compensation from SNIA for remediation costs relating to the environmental damage at chemical sites previously operated by SNIA’s other subsidiaries. In September 2011 and July 2014, the Bankruptcy Court of Udine and the Bankruptcy Court of Milan, respectively, held (in proceedings to which we are not parties) that the Italian Ministry of the Environment and other Italian government agencies (the “Public Administrations”) were not creditors of either SNIA or its subsidiaries in connection with their claims in the Italian insolvency proceedings. The Public Administrations appealed and in January 2016, the Court of Udine rejected the appeal. The Public Administrations has appealed that decision to the Supreme Court. Meanwhile, the Bankruptcy Court of Milan’s decision has been appealed. In January 2012, SNIA filed a civil action against Sorin in the Civil Court of Milan asserting joint liability of a parent and a spun-off company. The Public Administrations intervened in the proceeding, with a claim for environmental damages of approximately $4 billion. On April 1, 2016, the Court of Milan dismissed all legal actions of SNIA and of the Public Administrations further requiring the Public Administrations to pay Sorin approximately €292,000 (approximately $342,000 as of September 30, 2020) for legal fees. The Public Administrations appealed the 2016 Decision to the Court of Appeal of Milan, and on March 5, 2019, the Court of Appeal issued a partial decision on the merits declaring Sorin/LivaNova jointly liable with SNIA for SNIA’s environmental liabilities in an amount up to the fair value of the net worth received by Sorin because of the Sorin spin-off, an estimated €572.1 million (approximately $669.1 million as of September 30, 2020). Additionally the Court issued a separate order, staying the proceeding until a panel of three experts can assess the environmental damages, the costs of clean-up, and the costs that the Public Administrations has already borne for the clean-up of the sites to allow the Court to decide on the second claim of the Public Administration against LivaNova, (i.e., to refund the Public Administrations for the SNIA environmental liabilities). Both LivaNova and the Public Administrations have appealed the decision to the Italian Supreme Court (Corte di Cassazione). We have not recognized an expense in connection with this matter because any potential loss is not currently probable or reasonably estimable. In addition, we cannot reasonably estimate a range of potential loss, if any, that may result from this matter. Patent Litigation On May 11, 2018, Neuro and Cardiac Technologies LLC (“NCT”), a non-practicing entity, filed a complaint in the United States District Court for the Southern District of Texas asserting that the VNS Therapy System, when used with the SenTiva Model 1000 generator, infringes the claims of U.S. Patent No. 7,076,307 owned by NCT. The complaint requests damages that include a royalty, costs, interest, and attorneys’ fees. On September 13, 2018, we petitioned the Patent Trial and Appeal Board of the U.S. Patent and Trademark Office (the “Patent Office”) for an inter partes review (“IPR”) of the validity of the ‘307 patent, and on May 18, 2020, the Patent Office issued a Final Written Decision determining that all challenged claims are unpatentable. NCT is appealing the Final Written Decision. On March 24, 2020, we were granted our request for an ex parte reexamination of the ‘307 patent, and in August, the Patent Office issued a Non-Final Rejection of all of the ‘307 claims. The Court has stayed the litigation pending the outcome of the IPR appeal proceeding. We have not recognized an expense in connection with this matter because any potential loss is not currently probable or reasonably estimable. In addition, we cannot reasonably estimate a range of potential loss, if any, that may result from this matter. Contract Litigation On November 25, 2019, LivaNova received notice of a lawsuit initiated by former members of Caisson Interventional, LLC (“Caisson”), a subsidiary of the Company acquired in 2017. The lawsuit, Todd J. Mortier, as Member Representative of the former Members of Caisson Interventional, LLC v. LivaNova USA, Inc., is currently pending in the United States District Court for the District of Minnesota. The complaint alleges (i) breach of contract, (ii) breach of the covenant of good faith and fair dealing and (iii) unjust enrichment in connection with the Company’s operation of Caisson’s Transcatheter Mitral Valve Replacement (“TMVR”) program and the Company’s November 20, 2019 announcement that it was ending the TMVR program at the end of 2019. The lawsuit seeks damages arising out of the 2017 acquisition agreement, including various regulatory milestone payments. We intend to vigorously defend this claim. The Company has not recognized an expense related to this matter because any potential loss is not currently probable or reasonably estimable. In addition, we cannot reasonably estimate a range of potential loss, if any, that may result from this matter. Tax Litigation In a tax audit report received on October 30, 2009, the Regional Internal Revenue Office of Lombardy (the “Internal Revenue Office”) informed Sorin Group Italia S.r.l. that, among several issues, it was disallowing in part a tax-deductible write down of the investment in the U.S. company, Cobe Cardiovascular Inc., which Sorin Group Italia S.r.l. recognized in 2002 and deducted in five equal installments, beginning in 2002. In December 2009, the Internal Revenue Office issued notices of assessment for 2004. In December 2010 and October 2011, the Internal Revenue Office issued notices of assessment for 2005 and 2006, respectively. We challenged all three notices of assessment (for 2004, 2005 and 2006) before the relevant Provincial Tax Courts. The total amount of losses in dispute was €62.6 million (approximately $73.2 million as of September 30, 2020). On May 31, 2019, we filed an application to settle the litigation according to law N. 136/2018 and paid the required settlement balance of €1.9 million. As per law N. 136/2018, the Italian Revenue Agency reviewed the settlement and accepted the application by default on July 31, 2020. We recognized a benefit of €5.4 million, approximately $6.5 million, during the third quarter of 2020 as compared to the previously recognized reserve for an uncertain tax position of €15.5 million. The difference of €10.1 million (approximately $11.8 million as of September 30, 2020) was a fully valued deferred tax asset for net operating losses, the reversal of which does not impact the condensed consolidated statement of income (loss). Other Matters Additionally, we are the subject of various pending or threatened legal actions and proceedings that arise in the ordinary course of our business. These matters are subject to many uncertainties and outcomes that are not predictable and that may not be known for extended periods of time. Since the outcome of these matters cannot be predicted with certainty, the costs associated with them could have a material adverse effect on our consolidated net income, financial position or liquidity.

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2020
Stockholders' Equity Note [Abstract]
Stockholders' Equity	Note 11. Stockholders’ Equity The tables below present the condensed consolidated statement of stockholders’ equity as of and for the three and nine months ended September 30, 2020 and 2019 (in thousands): Ordinary Shares Ordinary Shares - Amount Additional Paid-In Capital Treasury Stock Accumulated Other Comprehensive Loss Accumulated Deficit Total Stockholders' Equity June 30, 2020 49,476 $ 76,338 $ 1,750,798 $ (1,057) $ (35,089) $ (457,804) $ 1,333,186 Stock-based compensation plans — — 7,670 4 — — 7,674 Cancellation of shares (73) — — — — — — Net loss — — — — — (14,772) (14,772) Other comprehensive income — — — — 24,704 — 24,704 September 30, 2020 49,403 $ 76,338 $ 1,758,468 $ (1,053) $ (10,385) $ (472,576) $ 1,350,792 June 30, 2019 49,380 $ 76,217 $ 1,717,220 $ (1,292) $ (13,174) $ (295,643) $ 1,483,328 Stock-based compensation plans 1 — 8,262 10 — — 8,272 Net income — — — — — 32,118 32,118 Other comprehensive loss — — — — (28,436) — (28,436) September 30, 2019 49,381 $ 76,217 $ 1,725,482 $ (1,282) $ (41,610) $ (263,525) $ 1,495,282 Ordinary Shares Ordinary Shares - Amount Additional Paid-In Capital Treasury Stock Accumulated Other Comprehensive Loss Accumulated Deficit Total Stockholders' Equity December 31, 2019 49,411 $ 76,257 $ 1,734,870 $ (1,263) $ (19,392) $ (406,755) $ 1,383,717 Adoption of ASU No. 2016-13 (1) — — — — — (639) (639) Stock-based compensation plans 65 81 23,598 210 — — 23,889 Cancellation of shares (73) — — — — — — Net loss — — — — — (65,182) (65,182) Other comprehensive income — — — — 9,007 — 9,007 September 30, 2020 49,403 $ 76,338 $ 1,758,468 $ (1,053) $ (10,385) $ (472,576) $ 1,350,792 December 31, 2018 49,323 $ 76,144 $ 1,705,111 $ (1,462) $ (24,476) $ (251,579) $ 1,503,738 Stock-based compensation plans 58 73 20,371 180 — — 20,624 Net loss — — — — — (11,946) (11,946) Other comprehensive loss — — — — (17,134) — (17,134) September 30, 2019 49,381 $ 76,217 $ 1,725,482 $ (1,282) $ (41,610) $ (263,525) $ 1,495,282 (1) Refer to “Note 17. New Accounting Pronouncements” The table below presents the change in each component of AOCI, net of tax, and the reclassifications out of AOCI into net income for the nine months ended September 30, 2020 and 2019 (in thousands): Change in Unrealized Gain (Loss) on Derivatives Foreign Currency Translation Adjustments Gain (Loss) (1) Total December 31, 2019 $ 513 $ (19,905) $ (19,392) Other comprehensive income before reclassifications, before tax 632 8,008 8,640 Tax expense (152) — (152) Other comprehensive income before reclassifications, net of tax 480 8,008 8,488 Reclassification of loss from accumulated other comprehensive loss, before tax 681 — 681 Reclassification of tax benefit (162) — (162) Reclassification of loss from accumulated other comprehensive loss, after tax 519 — 519 Net current-period other comprehensive income, net of tax 999 8,008 9,007 September 30, 2020 $ 1,512 $ (11,897) $ (10,385) December 31, 2018 $ (944) $ (23,532) $ (24,476) Other comprehensive income (loss) before reclassifications, before tax 933 (16,628) (15,695) Tax expense (224) — (224) Other comprehensive income (loss) before reclassifications, net of tax 709 (16,628) (15,919) Reclassification of gain from accumulated other comprehensive loss, before tax (1,598) — (1,598) Reclassification of tax expense 383 — 383 Reclassification of gain from accumulated other comprehensive loss, after tax (1,215) — (1,215) Net current-period other comprehensive loss, net of tax (506) (16,628) (17,134) September 30, 2019 $ (1,450) $ (40,160) $ (41,610) (1) Taxes are not provided for foreign currency translation adjustments as translation adjustments are related to earnings that are intended to be reinvested in the countries where earned.

Stock-Based Incentive Plans

Stock-Based Incentive Plans	9 Months Ended
	Sep. 30, 2020
Share-based Payment Arrangement [Abstract]
Stock-Based Incentive Plans	Note 12. Stock-Based Incentive Plans Stock-based incentive plans compensation expense is as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Service-based restricted stock units (“RSUs”) $ 4,410 $ 3,583 $ 13,139 $ 10,428 Service-based stock appreciation rights (“SARs”) 3,211 2,896 9,185 7,804 Market performance-based restricted stock units 814 757 2,745 2,146 Operating performance-based restricted stock units (962) 983 882 2,752 Employee share purchase plan 337 312 894 997 Total stock-based compensation expense $ 7,810 $ 8,531 $ 26,845 $ 24,127 During the nine months ended September 30, 2020, we issued stock-based compensatory awards with terms approved by the Compensation Committee of our Board of Directors. The awards with service conditions generally vest ratably over four years, subject to forfeiture unless service conditions are met. Market performance-based awards cliff vest after three years subject to the rank of our total shareholder return for the three-year period ending December 31, 2022 relative to the total shareholder returns for a peer group of companies. Operating performance-based awards cliff vest after three years subject to the achievement of certain thresholds of cumulative adjusted free cash flow for the three year period ending December 31, 2022. Compensation expense related to awards granted during 2020 for the three and nine months ended September 30, 2020 was $3.3 million and $6.6 million, respectively. Stock-based compensation agreements issued during the nine months ended September 30, 2020, representing potential shares and their weighted average grant date fair values by type follows (shares in thousands, fair value in dollars): Nine Months Ended September 30, 2020 Shares Weighted Average Grant Date Fair Value Service-based SARs 1,133 $ 15.73 Service-based RSUs 599 $ 44.42 Market performance-based RSUs 93 $ 39.83 Operating performance-based RSUs 93 $ 43.57

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2020
Income Tax Disclosure [Abstract]
Income Taxes	Note 13. Income Taxes Our effective income tax rate from continuing operations for the three and nine months ended September 30, 2020 was 21.3% and (37.9)% compared with (49.6)% and 65.9% for the three and nine months ended September 30, 2019, respectively. Our effective income tax rate fluctuates based on, among other factors, changes in pretax income in countries with varying statutory tax rates, changes in valuation allowances, changes in tax credits and incentives, and changes in unrecognized tax benefits associated with uncertain tax positions. We continually assess the realizability of our worldwide deferred tax asset and valuation allowance positions, and when the need arises, we establish or release valuation allowances accordingly. Compared with the three months ended September 30, 2019, the change in the effective tax rate for the three months ended September 30, 2020 was primarily attributable to a discrete tax benefit due to the release of the uncertain tax position upon the settlement of tax litigation in Italy offset by a valuation allowance for certain jurisdictions outside the U.S., as compared to a U.S. federal tax benefit from a return to provision reconciliation, partially offset by the establishment of a valuation allowance for a portion of the U.S. federal and state net operating losses during the three months ended September 30, 2019. We established valuation allowances as it is more likely than not that we will be unable to realize the related historical deferred tax assets. Compared with the nine months ended September 30, 2019, the change in the effective tax rate for the nine months ended September 30, 2020 was primarily attributable to a $42.4 million realized discrete tax benefit related to the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) and the discrete tax benefit due to the release of the uncertain tax position upon the settlement of tax litigation in Italy offset by the establishment of a $74.5 million valuation allowance for the U.K. and other jurisdictions outside the U.S., as compared to a release of uncertain tax positions and a U.S. federal tax benefit from a return to provision reconciliation, partly offset by the establishment of a valuation allowance for a portion of the U.S. federal and state net operating losses and attributes during the nine months ended September 30, 2019. We operate in multiple jurisdictions throughout the world, and our tax returns are periodically audited or subjected to review by tax authorities. As a result, there is an uncertainty in income taxes recognized in our financial statements. Tax benefits totaling $4.0 million and $12.9 million were unrecognized as of September 30, 2020 and December 31, 2019, respectively. It is reasonably possible that, within the next twelve months, due to the settlement of uncertain tax positions with various tax authorities and the expiration of statutes of limitations, unrecognized tax benefits could decrease by up to approximately $0.7 million. We monitor income tax developments in countries where we conduct business. On March 27, 2020, the U.S. enacted the CARES Act which provided for a 5-year loss carryback for losses incurred in 2018-2020. We recorded a discrete tax benefit of $42.4 million to account for the effect of the CARES Act during the nine months ended September 30, 2020. Further regulations and notices as well as state legislative changes addressing conformity to the CARES Act are still pending.

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2020
Earnings Per Share [Abstract]
Earnings Per Share	Note 14. Earnings Per Share Reconciliation of the shares used in the basic and diluted earnings per share computations for the three and nine months ended September 30, 2020 and 2019 are as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Basic weighted average shares outstanding 48,652 48,395 48,582 48,329 Add effects of share-based compensation instruments (1) — 425 — — Diluted weighted average shares outstanding 48,652 48,820 48,582 48,329 (1) Excluded from the computation of diluted earnings per share were stock options, SARs and restricted share units totaling 4.1 million and 1.4 million for the three months ended September 30, 2020 and 2019, respectively, and 4.2 million and 3.2 million for the nine months ended September 30, 2020 and 2019, respectively, because to include them would have been anti-dilutive under the treasury stock method.

Geographic and Segment Informat

Geographic and Segment Information	9 Months Ended
	Sep. 30, 2020
Segment Reporting [Abstract]
Geographic and Segment Information	Note 15. Geographic and Segment Information We identify operating segments based on the way we manage, evaluate and internally report our business activities for purposes of allocating resources, developing and executing our strategy, and assessing performance. We have two reportable segments: Cardiovascular and Neuromodulation. The Cardiovascular segment generates its revenue from the development, production and sale of cardiopulmonary products, heart valves and related products and advanced circulatory support. Cardiopulmonary products include oxygenators, heart-lung machines, autotransfusion systems, perfusion tubing systems, cannulae and other related accessories. Heart valves include mechanical heart valves, tissue heart valves, related repair products and minimally invasive surgical instruments. Advanced circulatory support includes temporary life support controllers and product kits that can include a combination of pumps, oxygenators, and cannulae. Our Neuromodulation segment generates its revenue from the design, development and marketing of neuromodulation therapy systems for the treatment of drug-resistant epilepsy, difficult-to-treat depression (“DTD”) and obstructive sleep apnea. Neuromodulation products include the VNS Therapy System, which consists of an implantable pulse generator, a lead that connects the generator to the vagus nerve, and other accessories. “Other” includes corporate shared service expenses for finance, legal, human resources, information technology and corporate business development. Net sales of our reportable segments include revenues from the sale of products they each develop and manufacture or distribute. We define segment income as operating income before merger and integration, restructuring and amortization of intangibles. We operate under three geographic regions: U.S., Europe, and Rest of World. The table below presents net sales by operating segment and geographic region (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Cardiopulmonary United States $ 33,549 $ 39,054 $ 96,223 $ 119,580 Europe 29,947 30,052 87,475 99,933 Rest of World 43,704 50,908 140,925 152,650 107,200 120,014 324,623 372,163 Heart Valves United States 3,129 4,626 8,990 13,660 Europe 7,945 9,572 22,822 30,757 Rest of World 10,062 14,679 32,001 43,484 21,136 28,877 63,813 87,901 Advanced Circulatory Support United States 12,331 6,313 28,075 22,290 Europe 162 186 835 497 Rest of World 49 36 136 310 12,542 6,535 29,046 23,097 Cardiovascular United States 49,009 49,993 133,288 155,530 Europe 38,054 39,810 111,132 131,187 Rest of World 53,815 65,623 173,062 196,444 140,878 155,426 417,482 483,161 Neuromodulation United States 79,854 88,433 197,345 245,870 Europe 10,475 10,425 27,474 34,080 Rest of World 8,079 13,685 20,458 31,511 98,408 112,543 245,277 311,461 Other 797 641 1,927 1,958 Totals United States 128,863 138,426 330,633 401,400 Europe (1) 48,529 50,235 138,606 165,267 Rest of World 62,691 79,949 195,447 229,913 Total (2) $ 240,083 $ 268,610 $ 664,686 $ 796,580 (1) Europe sales include those countries in which we have a direct sales presence, whereas European countries in which we sell through distributors are included in Rest of World. (2) No single customer represented over 10% of our consolidated net sales. No country’s net sales exceeded 10% of our consolidated sales except for the U.S. The table below presents a reconciliation of segment income from continuing operations to consolidated (loss) income from continuing operations before tax (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Cardiovascular $ (7,311) $ 36,180 $ (8,037) $ 47,289 Neuromodulation 21,154 30,010 82,294 52,260 Other (10,921) (21,869) (58,407) (75,845) Total reportable segment income from continuing operations 2,922 44,321 15,850 23,704 Merger and integration expenses 1,094 6,716 6,616 14,345 Restructuring expenses (349) 698 2,025 4,563 Amortization of intangibles 9,685 11,146 29,346 29,690 Operating (loss) income from continuing operations (7,508) 25,761 (22,137) (24,894) Interest income 47 151 482 624 Interest expense (14,673) (4,774) (25,237) (10,490) Foreign exchange and other gains (losses) 3,420 327 507 (795) (Loss) income from continuing operations before tax $ (18,714) $ 21,465 $ (46,385) $ (35,555) Assets by segment are as follows (in thousands): September 30, 2020 December 31, 2019 Cardiovascular $ 1,463,523 $ 1,546,520 Neuromodulation 668,899 749,069 Other 389,326 116,208 Total assets $ 2,521,748 $ 2,411,797 Capital expenditures by segment are as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Cardiovascular $ 7,040 $ 5,178 $ 17,777 $ 13,564 Neuromodulation 1,210 136 7,285 666 Other 967 691 3,174 2,571 Total $ 9,217 $ 6,005 $ 28,236 $ 16,801 The changes in the carrying amount of goodwill by segment for the nine months ended September 30, 2020 were as follows (in thousands): Neuromodulation Cardiovascular Total December 31, 2019 $ 398,754 $ 517,040 $ 915,794 Foreign currency adjustments — 2,684 2,684 September 30, 2020 $ 398,754 $ 519,724 $ 918,478 Property, plant and equipment, net by geography are as follows (in thousands): September 30, 2020 December 31, 2019 United States $ 64,620 $ 61,410 Europe 116,746 110,270 Rest of World 9,143 9,674 Total $ 190,509 $ 181,354

Supplemental Financial Informat

Supplemental Financial Information	9 Months Ended
	Sep. 30, 2020
Balance Sheet Related Disclosures [Abstract]
Supplemental Financial Information	Note 16. Supplemental Financial Information Inventories consisted of the following (in thousands): September 30, 2020 December 31, 2019 Raw materials $ 48,325 $ 45,225 Work-in-process 18,949 14,581 Finished goods 110,817 104,348 $ 178,091 $ 164,154 As of September 30, 2020 and December 31, 2019, inventories include adjustments totaling $14.5 million and $12.7 million, respectively, to record balances at lower of cost or net realizable value. Accrued liabilities and other consisted of the following (in thousands): September 30, 2020 December 31, 2019 Contingent consideration (1) $ 16,571 $ 22,953 Legal and administrative costs 14,034 11,066 Operating lease liabilities 11,941 11,110 Contract liabilities 7,723 6,728 Research and development costs 5,328 5,160 Provisions for agents, returns and other 3,772 3,922 Restructuring related liabilities (2) 1,813 4,315 Product remediation (3) 1,715 3,251 Derivative contract liabilities (4) 1,338 3,173 CRM purchase price adjustment payable to MicroPort Scientific Corporation — 14,891 Other accrued expenses 34,073 33,531 $ 98,308 $ 120,100 (1) Refer to “Note 7. Fair Value Measurements” (2) Refer to “Note 4. Restructuring” (3) Refer to “Note 5. Product Remediation Liability” (4) Refer to “ Note 9. Derivatives and Risk Management” As of September 30, 2020 and December 31, 2019, contract liabilities of $9.5 million and $8.6 million, respectively, are included within accrued liabilities and other long-term liabilities on the condensed consolidated balance sheets.

New Accounting Pronouncements

New Accounting Pronouncements	9 Months Ended
	Sep. 30, 2020
Accounting Standards Update and Change in Accounting Principle [Abstract]
New Accounting Pronouncements	Note 17. New Accounting Pronouncements Adoption of New Accounting Pronouncements The following table provides a description of our adoption of new Accounting Standards Updates (“ASUs”) issued by the FASB and the impact of the adoption on our condensed financial statements: Issue Date & Standard Description Date of Adoption Effect on Financial Statements or Other Significant Matters June 2016 ASU No. 2016-13 The amendments in this update require a financial asset (or a group of financial assets) measured at amortized cost basis to be presented at the net amount expected to be collected. We adopted the update effective January 1, 2020 We recognized the following cumulative-effect adjustments, including to retained earnings, upon adoption at January 1, 2020: Accounts receivable, net decreased $0.6 million and accumulated deficit increased $0.6 million. January 2017 ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment This update removes step 2 of the goodwill impairment test that compares the implied fair value of goodwill with its carrying amount. Instead, an impairment test is performed by comparing the fair value of a reporting unit with its carrying amount. An impairment charge will be recorded by the amount a reporting unit’s carrying amount exceeds its fair value. January 1, 2020 There was no material impact to our consolidated financial statements as a result of adopting this ASU. August 2018 ASU No. 2018-13, Fair Value Measurement (Topic 820): Changes to the Disclosure Requirements for Fair Value Measurement This update removes, modifies and adds certain disclosure requirements related to fair value measurements. January 1, 2020 There was no material impact to our consolidated financial statements as a result of adopting this ASU. August 2018 ASU No. 2018-15, Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract This update clarifies and aligns the accounting for implementation costs for hosting arrangements with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. January 1, 2020 There was no material impact to our consolidated financial statements as a result of adopting this ASU. Future Adoption of New Accounting Pronouncements The following table provides a description of future adoptions of new accounting standards that may have an impact on our financial statements when adopted: Issue Date & Standard Description Projected Date of Adoption Effect on Financial Statements or Other Significant Matters August 2018 ASU No. 2018-14, Compensation—Retirement Benefits—Defined Benefit Plans—General (Subtopic 715-20): Changes to the Disclosure Requirements for Defined Benefit Plans This update adds and removes certain disclosure requirements related to defined benefit plans. This ASU is to be implemented on a retrospective basis for all periods presented with early adoption permitted. January 1, 2021 We do not expect the adoption of this update to have a material effect on our condensed consolidated financial statement disclosures.

Unaudited Condensed Consolida_2

Unaudited Condensed Consolidated Financial Statements (Policies)	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying condensed consolidated financial statements of LivaNova as of, and for the three and nine months ended September 30, 2020 and 2019, have been prepared in accordance with U.S. GAAP for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. The accompanying condensed consolidated balance sheet of LivaNova at December 31, 2019 has been derived from audited financial statements contained in our 2019 Form 10-K, but does not include all of the information and footnotes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments (consisting of only normal recurring adjustments) considered necessary for a fair statement of the operating results of LivaNova and its subsidiaries, for the three and nine months ended September 30, 2020, and are not necessarily indicative of the results that may be expected for the year ending December 31, 2020. The financial information presented herein should be read in conjunction with the audited consolidated financial statements and notes thereto accompanying our 2019 Form 10-K.
Reclassifications	Reclassifications We have reclassified certain prior period amounts for comparative purposes. These reclassifications did not have a material effect on our financial condition, results of operations or cash flows.
Derivatives	If the derivative qualifies for hedge accounting, changes in the fair value of the derivative will be recorded in accumulated other comprehensive income (“AOCI”) until the hedged item is recognized in earnings upon settlement/termination. FX derivative gains and losses in AOCI are reclassified to our condensed consolidated statements of income (loss) as shown in the tables below. We evaluate hedge effectiveness at inception. Cash flows from derivative contracts are reported as operating activities on our condensed consolidated statements of cash flows.
Adoption of New Accounting Pronouncements	Adoption of New Accounting Pronouncements The following table provides a description of our adoption of new Accounting Standards Updates (“ASUs”) issued by the FASB and the impact of the adoption on our condensed financial statements: Issue Date & Standard Description Date of Adoption Effect on Financial Statements or Other Significant Matters June 2016 ASU No. 2016-13 The amendments in this update require a financial asset (or a group of financial assets) measured at amortized cost basis to be presented at the net amount expected to be collected. We adopted the update effective January 1, 2020 We recognized the following cumulative-effect adjustments, including to retained earnings, upon adoption at January 1, 2020: Accounts receivable, net decreased $0.6 million and accumulated deficit increased $0.6 million. January 2017 ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment This update removes step 2 of the goodwill impairment test that compares the implied fair value of goodwill with its carrying amount. Instead, an impairment test is performed by comparing the fair value of a reporting unit with its carrying amount. An impairment charge will be recorded by the amount a reporting unit’s carrying amount exceeds its fair value. January 1, 2020 There was no material impact to our consolidated financial statements as a result of adopting this ASU. August 2018 ASU No. 2018-13, Fair Value Measurement (Topic 820): Changes to the Disclosure Requirements for Fair Value Measurement This update removes, modifies and adds certain disclosure requirements related to fair value measurements. January 1, 2020 There was no material impact to our consolidated financial statements as a result of adopting this ASU. August 2018 ASU No. 2018-15, Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract This update clarifies and aligns the accounting for implementation costs for hosting arrangements with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. January 1, 2020 There was no material impact to our consolidated financial statements as a result of adopting this ASU. Future Adoption of New Accounting Pronouncements The following table provides a description of future adoptions of new accounting standards that may have an impact on our financial statements when adopted: Issue Date & Standard Description Projected Date of Adoption Effect on Financial Statements or Other Significant Matters August 2018 ASU No. 2018-14, Compensation—Retirement Benefits—Defined Benefit Plans—General (Subtopic 715-20): Changes to the Disclosure Requirements for Defined Benefit Plans This update adds and removes certain disclosure requirements related to defined benefit plans. This ASU is to be implemented on a retrospective basis for all periods presented with early adoption permitted. January 1, 2021 We do not expect the adoption of this update to have a material effect on our condensed consolidated financial statement disclosures.

Restructuring (Tables)

Restructuring (Tables)	9 Months Ended
	Sep. 30, 2020
Restructuring and Related Activities [Abstract]
Schedule of Restructuring and Related Costs	The following table provides a reconciliation of the beginning and ending balance of the accruals and other reserves recorded in connection with our restructuring plans included within accrued liabilities and other and other long-term liabilities on the condensed consolidated balance sheet (in thousands): Employee Severance and Other Termination Costs Other Total Balance at December 31, 2019 $ 4,097 $ 1,400 $ 5,497 Charges 2,025 — 2,025 Cash payments and other (4,880) (792) (5,672) Balance at September 30, 2020 $ 1,242 $ 608 $ 1,850
Schedule of Restructuring Expense by Reportable Segment	The following table presents restructuring expense by reportable segment (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Cardiovascular $ 9 $ 783 $ 1,265 $ 1,521 Neuromodulation 43 (171) 851 314 Other (401) 86 (91) 2,728 Total $ (349) $ 698 $ 2,025 $ 4,563

Product Remediation Liability (

Product Remediation Liability (Tables)	9 Months Ended
	Sep. 30, 2020
Product Remediation [Abstract]
Product Liability Contingencies	The following table provides a reconciliation of the beginning and ending balance of the product remediation liability included within accrued liabilities and other on the condensed consolidated balance sheet (in thousands): Balance at December 31, 2019 $ 3,251 Adjustments 2,301 Remediation activity (3,982) Effect of changes in foreign currency exchange rates 145 Balance at September 30, 2020 $ 1,715

Investments (Tables)

Investments (Tables)	9 Months Ended
	Sep. 30, 2020
Investments [Abstract]
Schedule of Long-term Investments	The below equity investments are included in investments on the condensed consolidated balance sheets (in thousands): Equity Investments Without Readily Determinable Fair Values September 30, 2020 December 31, 2019 Respicardia Inc. (1) $ 17,706 $ 17,706 ALung Technologies, Inc. (2) 3,000 — Ceribell, Inc. 3,000 3,000 ShiraTronics, Inc. 2,045 2,045 MD Start II 1,169 1,121 Rainbow Medical Ltd. 1,145 1,099 Highlife S.A.S. 1,109 1,064 Other 770 770 29,944 26,805 Equity method investment 414 451 $ 30,358 $ 27,256 (1) Respicardia Inc. (“Respicardia”) is a privately funded U.S. company developing an implantable device designed to restore a more natural breathing pattern during sleep in patients with central sleep apnea by transvenously stimulating the phrenic nerve. We have a loan outstanding to Respicardia, with a carrying amount of $0.8 million and $0.6 million as of September 30, 2020 and December 31, 2019, respectively, which is included in prepaid expenses and other current assets on the condensed consolidated balance sheet. (2) During the first quarter of 2020, we invested in ALung Technologies, Inc. (“ALung”). ALung is a privately held medical device company focused on creating advanced medical devices for treating respiratory failure. ALung’s Hemolung Respiratory Assist System is a dialysis-like alternative or supplement to mechanical ventilation which removes carbon dioxide directly from the blood in patients with acute respiratory failure. During the second quarter of 2020, we provided a convertible loan to ALung for $2.0 million, due July 10, 2021. As of September 30, 2020, the carrying amount of the loan was $2.0 million, which is included in prepaid expenses and other current assets on the condensed consolidated balance sheet.

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2020
Fair Value Disclosures [Abstract]
Fair Value Measurements on a Recurring Basis	The following tables provide information by level for assets and liabilities that are measured at fair value on a recurring basis (in thousands): Fair Value as of September 30, 2020 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets: Derivative assets - designated as cash flow hedges (foreign currency exchange rate “FX”) $ 1,787 $ — $ 1,787 $ — Derivative assets - freestanding instruments (FX) 4,052 — 4,052 — Derivative assets - capped call derivatives 38,999 — — 38,999 Convertible notes receivable 2,301 — — 2,301 $ 47,139 $ — $ 5,839 $ 41,300 Liabilities: Derivative liabilities - freestanding instruments (interest rate swaps) $ 139 $ — $ 139 $ — Derivative liabilities - freestanding instruments (FX) 85 — 85 — Derivative liabilities - embedded exchange feature 59,398 — — 59,398 Derivative liabilities - other 1,350 — — 1,350 Contingent consideration arrangements 96,174 — — 96,174 $ 157,146 $ — $ 224 $ 156,922 Fair Value as of December 31, 2019 Fair Value Measurements Using Inputs Considered as: Level 1 Level 2 Level 3 Assets: Derivative assets - designated as cash flow hedges (FX) $ 535 $ — $ 535 $ — Derivative assets - freestanding instruments (FX) 26 — 26 — $ 561 $ — $ 561 $ — Liabilities: Derivative liabilities - designated as cash flow hedges (FX) $ 169 $ — $ 169 $ — Derivative liabilities - designated as cash flow hedges (interest rate swaps) 374 — 374 — Derivative liabilities - freestanding instruments (FX) 3,137 — 3,137 — Contingent consideration arrangements 137,349 — — 137,349 $ 141,029 $ — $ 3,680 $ 137,349
Reconciliation of Beginning and Ending Balances of Contingent Consideration	The following table provides a reconciliation of the beginning and ending balances of our recurring fair value measurements, using significant unobservable inputs (Level 3) (in thousands): Capped Call Derivative Asset Embedded Exchange Feature Derivative Liability Other Derivative Liabilities Contingent Consideration Liability Arrangements Convertible Notes Receivable As of December 31, 2019 $ — $ — $ — $ 137,349 $ — Additions 43,096 74,951 — — 2,267 Payments (1) — — — (9,868) — Changes in fair value (2) (3) (4) (4,097) (15,553) 1,350 (31,176) 34 Effect of changes in foreign currency exchange rates — — — (131) — Total at September 30, 2020 38,999 59,398 1,350 96,174 2,301 Less current portion at September 30, 2020 — — 1,160 16,571 2,044 Long-term portion at September 30, 2020 $ 38,999 $ 59,398 $ 190 $ 79,603 $ 257 (1) During the nine months ended September 30, 2020, we paid $8.8 million under the contingent consideration arrangement for the acquisition of CardiacAssist, Inc., doing business as TandemLife (“TandemLife”). Additionally, we made final payments under contingent consideration arrangements resulting from the acquisitions of two distributors. (2) The contingent consideration change in fair value during the nine months ended September 30, 2020 is primarily due to a one-year delay in the projected achievement of a certain regulatory milestone and timing of sales-based earnout payments for ImThera Medical Inc. (“ImThera”), and the impact of an increase in discount rates utilized in the valuation of contingent consideration. Refer to the tables below for further information regarding the fair value measurements of contingent consideration. (3) During the nine months ended September 30, 2020, the contingent consideration change in fair value resulted in a decrease of $19.2 million and $12.0 million recorded to cost of sales - exclusive of amortization and research and development, respectively. (4) Changes in the fair value of the embedded exchange feature derivative and capped call derivatives are recognized in foreign exchange and other gains (losses) in the condensed consolidated statements of income (loss).
Schedule of Business Acquisitions by Acquisition, Contingent Consideration	The following table provides the fair value of our Level 3 contingent consideration arrangements by acquisition (in thousands): September 30, 2020 December 31, 2019 ImThera $ 79,603 $ 113,503 TandemLife 11,672 17,311 Miami Instruments 4,899 5,338 Drilltex — 294 Other — 903 $ 96,174 $ 137,349
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation	Both arrangements are Level 3 fair value measurements and include the following significant unobservable inputs as of September 30, 2020: ImThera Acquisition Valuation Technique Unobservable Input Ranges Regulatory milestone-based payment Discounted cash flow Discount rate 8.3% Probability of payment 85% Projected payment year 2024 Sales-based earnout Monte Carlo simulation Risk-adjusted discount rate 12.2 % - 12.5% Credit risk discount rate 8.5 % - 9.2% Revenue volatility 32.5% Probability of payment 85% Projected years of earnout 2025 - 2028 The TandemLife business combination involved a contingent consideration arrangement composed of potential cash payments upon the achievement of certain regulatory milestones. The arrangement is a Level 3 fair value measurement and includes the following significant unobservable inputs as of September 30, 2020: TandemLife Acquisition Valuation Technique Unobservable Input Ranges Regulatory milestone-based payment Discounted cash flow Discount rate 7.6 % - 7.7% Probability of payments 70 % - 100% Projected payment years 2020 - 2021 The Miami Instruments business combination involved a contingent consideration arrangement composed of potential cash payments upon the achievement of certain regulatory milestones. The arrangement is a Level 3 fair value measurement and includes the following significant unobservable inputs as of September 30, 2020: Miami Instruments Valuation Technique Unobservable Input Ranges Regulatory milestone-based payments Discounted cash flow Discount rate 7.6 % - 7.7% Probability of payments 80 % - 95% Projected payment years 2020 - 2021

Financing Arrangements (Tables)

Financing Arrangements (Tables)	9 Months Ended
	Sep. 30, 2020
Debt Disclosure [Abstract]
Schedule of Long-term Debt	The carrying amount of our long-term debt as of September 30, 2020 and December 31, 2019 was as follows (in thousands, except interest rates): September 30, 2020 December 31, 2019 Maturity Interest Rate 2020 Senior Secured Term Loan $ 422,960 $ — June 2025 LIBOR (1% Floor) + 6.50% 2020 Cash Exchangeable Senior Notes 208,954 — December 2025 3.00% Bank of America Merrill Lynch Banco Múltiplo S.A. 6,000 8,422 July 2021 5.61% Mediocredito Italiano 5,835 6,222 December 2023 0.50 % - 2.77% Bank of America, U.S. 2,011 2,004 January 2021 2.08% 2019 Debt Facility — 184,275 2017 European Investment Bank — 103,570 2014 European Investment Bank — 28,053 Other 1,041 965 Total long-term facilities 646,801 333,511 Less current portion of long-term debt 9,692 73,181 Total long-term debt $ 637,109 $ 260,330
Schedule of Debt Covenants	The financial covenants under the Term Loan state (i) the net revenue of LivaNova PLC, LivaNova USA, Inc. and any restricted subsidiaries on a consolidated basis shall not be lower than $700 million for each trailing 12 month period, such threshold to decrease pro rata (not below $550 million) upon prepayments of the Term Loan made by LivaNova USA, Inc. out of the proceeds of certain asset sales, and (ii) the total secured leverage ratio (as defined in the debt agreement) for LivaNova PLC, LivaNova USA, Inc. and any restricted subsidiaries on a consolidated basis shall not be greater than the applicable ratio set forth below: Test Period Total Secured Leverage Ratio 4 Quarters ending June 30, 2020 through each fiscal quarter thereafter until (and including) the fiscal quarter ending June 30, 2021 5.625 : 1.00 4 Quarters ending September 30, 2021 and ending each fiscal quarter thereafter 4.5 : 1.00

Derivatives and Risk Manageme_2

Derivatives and Risk Management (Tables)	9 Months Ended
	Sep. 30, 2020
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Notional Amounts of Derivative Contracts Designated Cash Flow Hedges	The gross notional amounts of open derivative contracts designated as cash flow hedges at September 30, 2020 and December 31, 2019 were as follows (in thousands): Description of Derivative Contract September 30, 2020 December 31, 2019 FX derivative contracts to be exchanged for British Pounds $ 7,610 $ 10,128 FX derivative contracts to be exchanged for Japanese Yen 16,023 25,342 FX derivative contracts to be exchanged for Euros 36,553 48,838 Interest rate swap contracts (1) — 22,442 $ 60,186 $ 106,750 (1) Interest rate swap contracts were de-designated upon the repayment of the 2014 European Investment Bank loan. Refer to “Note 8. Financing Arrangements.”
Schedule of Cash Flow Hedges Included in AOCI	After-tax net loss associated with derivatives designated as cash flow hedges recorded in the ending balance of AOCI and the amount expected to be reclassified to earnings in the next twelve months are as follows (in thousands): Description of Derivative Contract After-Tax Net Gain in AOCI as of September 30, 2020 After-Tax Net Gain in AOCI as of Amount Expected to be Reclassified to Earnings in Next 12 Months FX derivative contracts $ 1,512 $ 1,512 Pre-tax gains (losses) for derivative contracts designated as cash flow hedges recognized in other comprehensive income (loss) (“OCI”) and the amount reclassified to earnings from AOCI were as follows (in thousands): Three Months Ended September 30, 2020 2019 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss Gains Recognized in OCI (Losses) Gains Reclassified from AOCI to Earnings Losses Recognized in OCI Gains (Losses) Reclassified from AOCI to Earnings FX derivative contracts Foreign exchange and other gains (losses) $ 1,482 $ (692) $ (689) $ 963 FX derivative contracts SG&A — 534 — (742) Interest rate swap contracts Interest expense — — — (40) $ 1,482 $ (158) $ (689) $ 181 Nine Months Ended September 30, 2020 2019 Description of Derivative Contract Location in Earnings of Reclassified Gain or Loss Gains Recognized in OCI (Losses) Gains Reclassified from AOCI to Earnings Gains Recognized in OCI Gains (Losses) Reclassified from AOCI to Earnings FX derivative contracts Foreign exchange and other gains (losses) $ 632 $ (777) $ 933 $ 3,094 FX derivative contracts SG&A — 209 — (1,470) Interest rate swap contracts Interest expense — (113) — (26) $ 632 $ (681) $ 933 $ 1,598
Schedule of Fair Value of Derivative Instruments in Statement of Financial Position	The following tables present the fair value and the location of derivative contracts reported on the condensed consolidated balance sheets (in thousands): September 30, 2020 Asset Derivatives Liability Derivatives Derivatives Designated as Hedging Instruments Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) FX derivative contracts Prepaid expenses and other current assets $ 1,775 FX derivative contracts Accrued liabilities 12 Total derivatives designated as hedging instruments 1,787 Derivatives Not Designated as Hedging Instruments Interest rate swap contracts Accrued liabilities $ 139 FX derivative contracts Prepaid expenses and other current assets 4,052 Accrued liabilities 51 FX derivative contracts Prepaid expense and other current assets 34 Capped call derivatives Other assets 38,999 Embedded exchange feature Long-term derivative liability 59,398 Other derivatives Accrued liabilities 1,160 Other derivatives Long-term derivative liability 190 Total derivatives not designated as hedging instruments 43,051 60,972 Total derivatives $ 44,838 $ 60,972 December 31, 2019 Asset Derivatives Liability Derivatives Derivatives Designated as Hedging Instruments Balance Sheet Location Fair Value (1) Balance Sheet Location Fair Value (1) Interest rate swap contracts Accrued liabilities $ 313 Interest rate swap contracts Long-term derivative liability 61 FX derivative contracts Prepaid expenses and other current assets $ 148 Accrued liabilities 169 FX derivative contracts Accrued liabilities 387 Total derivatives designated as hedging instruments 535 543 Derivatives Not Designated as Hedging Instruments FX derivative contracts Accrued liabilities 26 Accrued liabilities 3,104 FX derivative contracts Prepaid expenses and other current assets 33 Total derivatives not designated as hedging instruments 26 3,137 Total derivatives $ 561 $ 3,680 (1) For the classification of inputs used to evaluate the fair value of our derivatives, refer to “Note 7. Fair Value Measurements.”

Commitments and Contingencies (

Commitments and Contingencies (Tables)	9 Months Ended
	Sep. 30, 2020
Commitments and Contingencies Disclosure [Abstract]
Litigation Provision Liabilities	The changes in the litigation provision liability during the nine months ended September 30, 2020 are as follows (in thousands): Litigation Provision Liability Total litigation provision liability at December 31, 2019 $ 170,404 Payments (128,128) Adjustments 3,970 FX and other 54 Total litigation provision liability at September 30, 2020 46,300 Less current portion of litigation liability at September 30, 2020 34,790 Long-term portion of litigation provision liability at September 30, 2020 $ 11,510

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	9 Months Ended
	Sep. 30, 2020
Stockholders' Equity Note [Abstract]
Schedule of Stockholders Equity	The tables below present the condensed consolidated statement of stockholders’ equity as of and for the three and nine months ended September 30, 2020 and 2019 (in thousands): Ordinary Shares Ordinary Shares - Amount Additional Paid-In Capital Treasury Stock Accumulated Other Comprehensive Loss Accumulated Deficit Total Stockholders' Equity June 30, 2020 49,476 $ 76,338 $ 1,750,798 $ (1,057) $ (35,089) $ (457,804) $ 1,333,186 Stock-based compensation plans — — 7,670 4 — — 7,674 Cancellation of shares (73) — — — — — — Net loss — — — — — (14,772) (14,772) Other comprehensive income — — — — 24,704 — 24,704 September 30, 2020 49,403 $ 76,338 $ 1,758,468 $ (1,053) $ (10,385) $ (472,576) $ 1,350,792 June 30, 2019 49,380 $ 76,217 $ 1,717,220 $ (1,292) $ (13,174) $ (295,643) $ 1,483,328 Stock-based compensation plans 1 — 8,262 10 — — 8,272 Net income — — — — — 32,118 32,118 Other comprehensive loss — — — — (28,436) — (28,436) September 30, 2019 49,381 $ 76,217 $ 1,725,482 $ (1,282) $ (41,610) $ (263,525) $ 1,495,282 Ordinary Shares Ordinary Shares - Amount Additional Paid-In Capital Treasury Stock Accumulated Other Comprehensive Loss Accumulated Deficit Total Stockholders' Equity December 31, 2019 49,411 $ 76,257 $ 1,734,870 $ (1,263) $ (19,392) $ (406,755) $ 1,383,717 Adoption of ASU No. 2016-13 (1) — — — — — (639) (639) Stock-based compensation plans 65 81 23,598 210 — — 23,889 Cancellation of shares (73) — — — — — — Net loss — — — — — (65,182) (65,182) Other comprehensive income — — — — 9,007 — 9,007 September 30, 2020 49,403 $ 76,338 $ 1,758,468 $ (1,053) $ (10,385) $ (472,576) $ 1,350,792 December 31, 2018 49,323 $ 76,144 $ 1,705,111 $ (1,462) $ (24,476) $ (251,579) $ 1,503,738 Stock-based compensation plans 58 73 20,371 180 — — 20,624 Net loss — — — — — (11,946) (11,946) Other comprehensive loss — — — — (17,134) — (17,134) September 30, 2019 49,381 $ 76,217 $ 1,725,482 $ (1,282) $ (41,610) $ (263,525) $ 1,495,282 (1) Refer to “Note 17. New Accounting Pronouncements”
Schedule of Accumulated Other Comprehensive Income (Loss)	The table below presents the change in each component of AOCI, net of tax, and the reclassifications out of AOCI into net income for the nine months ended September 30, 2020 and 2019 (in thousands): Change in Unrealized Gain (Loss) on Derivatives Foreign Currency Translation Adjustments Gain (Loss) (1) Total December 31, 2019 $ 513 $ (19,905) $ (19,392) Other comprehensive income before reclassifications, before tax 632 8,008 8,640 Tax expense (152) — (152) Other comprehensive income before reclassifications, net of tax 480 8,008 8,488 Reclassification of loss from accumulated other comprehensive loss, before tax 681 — 681 Reclassification of tax benefit (162) — (162) Reclassification of loss from accumulated other comprehensive loss, after tax 519 — 519 Net current-period other comprehensive income, net of tax 999 8,008 9,007 September 30, 2020 $ 1,512 $ (11,897) $ (10,385) December 31, 2018 $ (944) $ (23,532) $ (24,476) Other comprehensive income (loss) before reclassifications, before tax 933 (16,628) (15,695) Tax expense (224) — (224) Other comprehensive income (loss) before reclassifications, net of tax 709 (16,628) (15,919) Reclassification of gain from accumulated other comprehensive loss, before tax (1,598) — (1,598) Reclassification of tax expense 383 — 383 Reclassification of gain from accumulated other comprehensive loss, after tax (1,215) — (1,215) Net current-period other comprehensive loss, net of tax (506) (16,628) (17,134) September 30, 2019 $ (1,450) $ (40,160) $ (41,610) (1) Taxes are not provided for foreign currency translation adjustments as translation adjustments are related to earnings that are intended to be reinvested in the countries where earned.

Stock-Based Incentive Plans (Ta

Stock-Based Incentive Plans (Tables)	9 Months Ended
	Sep. 30, 2020
Share-based Payment Arrangement [Abstract]
Share-based Compensation, Stock Options, Activity	Stock-based incentive plans compensation expense is as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Service-based restricted stock units (“RSUs”) $ 4,410 $ 3,583 $ 13,139 $ 10,428 Service-based stock appreciation rights (“SARs”) 3,211 2,896 9,185 7,804 Market performance-based restricted stock units 814 757 2,745 2,146 Operating performance-based restricted stock units (962) 983 882 2,752 Employee share purchase plan 337 312 894 997 Total stock-based compensation expense $ 7,810 $ 8,531 $ 26,845 $ 24,127 Stock-based compensation agreements issued during the nine months ended September 30, 2020, representing potential shares and their weighted average grant date fair values by type follows (shares in thousands, fair value in dollars): Nine Months Ended September 30, 2020 Shares Weighted Average Grant Date Fair Value Service-based SARs 1,133 $ 15.73 Service-based RSUs 599 $ 44.42 Market performance-based RSUs 93 $ 39.83 Operating performance-based RSUs 93 $ 43.57

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2020
Earnings Per Share [Abstract]
Schedule of Basic and Diluted Net Income Per Share	Reconciliation of the shares used in the basic and diluted earnings per share computations for the three and nine months ended September 30, 2020 and 2019 are as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Basic weighted average shares outstanding 48,652 48,395 48,582 48,329 Add effects of share-based compensation instruments (1) — 425 — — Diluted weighted average shares outstanding 48,652 48,820 48,582 48,329 (1) Excluded from the computation of diluted earnings per share were stock options, SARs and restricted share units totaling 4.1 million and 1.4 million for the three months ended September 30, 2020 and 2019, respectively, and 4.2 million and 3.2 million for the nine months ended September 30, 2020 and 2019, respectively, because to include them would have been anti-dilutive under the treasury stock method.

Geographic and Segment Inform_2

Geographic and Segment Information (Tables)	9 Months Ended
	Sep. 30, 2020
Segment Reporting [Abstract]
Revenue from External Customers by Geographic Areas	The table below presents net sales by operating segment and geographic region (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Cardiopulmonary United States $ 33,549 $ 39,054 $ 96,223 $ 119,580 Europe 29,947 30,052 87,475 99,933 Rest of World 43,704 50,908 140,925 152,650 107,200 120,014 324,623 372,163 Heart Valves United States 3,129 4,626 8,990 13,660 Europe 7,945 9,572 22,822 30,757 Rest of World 10,062 14,679 32,001 43,484 21,136 28,877 63,813 87,901 Advanced Circulatory Support United States 12,331 6,313 28,075 22,290 Europe 162 186 835 497 Rest of World 49 36 136 310 12,542 6,535 29,046 23,097 Cardiovascular United States 49,009 49,993 133,288 155,530 Europe 38,054 39,810 111,132 131,187 Rest of World 53,815 65,623 173,062 196,444 140,878 155,426 417,482 483,161 Neuromodulation United States 79,854 88,433 197,345 245,870 Europe 10,475 10,425 27,474 34,080 Rest of World 8,079 13,685 20,458 31,511 98,408 112,543 245,277 311,461 Other 797 641 1,927 1,958 Totals United States 128,863 138,426 330,633 401,400 Europe (1) 48,529 50,235 138,606 165,267 Rest of World 62,691 79,949 195,447 229,913 Total (2) $ 240,083 $ 268,610 $ 664,686 $ 796,580 (1) Europe sales include those countries in which we have a direct sales presence, whereas European countries in which we sell through distributors are included in Rest of World. (2) No single customer represented over 10% of our consolidated net sales. No country’s net sales exceeded 10% of our consolidated sales except for the U.S.
Schedule of Segment Reporting Information, by Segment	The table below presents a reconciliation of segment income from continuing operations to consolidated (loss) income from continuing operations before tax (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Cardiovascular $ (7,311) $ 36,180 $ (8,037) $ 47,289 Neuromodulation 21,154 30,010 82,294 52,260 Other (10,921) (21,869) (58,407) (75,845) Total reportable segment income from continuing operations 2,922 44,321 15,850 23,704 Merger and integration expenses 1,094 6,716 6,616 14,345 Restructuring expenses (349) 698 2,025 4,563 Amortization of intangibles 9,685 11,146 29,346 29,690 Operating (loss) income from continuing operations (7,508) 25,761 (22,137) (24,894) Interest income 47 151 482 624 Interest expense (14,673) (4,774) (25,237) (10,490) Foreign exchange and other gains (losses) 3,420 327 507 (795) (Loss) income from continuing operations before tax $ (18,714) $ 21,465 $ (46,385) $ (35,555) Assets by segment are as follows (in thousands): September 30, 2020 December 31, 2019 Cardiovascular $ 1,463,523 $ 1,546,520 Neuromodulation 668,899 749,069 Other 389,326 116,208 Total assets $ 2,521,748 $ 2,411,797 Capital expenditures by segment are as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Cardiovascular $ 7,040 $ 5,178 $ 17,777 $ 13,564 Neuromodulation 1,210 136 7,285 666 Other 967 691 3,174 2,571 Total $ 9,217 $ 6,005 $ 28,236 $ 16,801
Schedule of Goodwill	The changes in the carrying amount of goodwill by segment for the nine months ended September 30, 2020 were as follows (in thousands): Neuromodulation Cardiovascular Total December 31, 2019 $ 398,754 $ 517,040 $ 915,794 Foreign currency adjustments — 2,684 2,684 September 30, 2020 $ 398,754 $ 519,724 $ 918,478
Long-lived Assets by Geographic Areas	Property, plant and equipment, net by geography are as follows (in thousands): September 30, 2020 December 31, 2019 United States $ 64,620 $ 61,410 Europe 116,746 110,270 Rest of World 9,143 9,674 Total $ 190,509 $ 181,354

Supplemental Financial Inform_2

Supplemental Financial Information (Tables)	9 Months Ended
	Sep. 30, 2020
Balance Sheet Related Disclosures [Abstract]
Inventories	Inventories consisted of the following (in thousands): September 30, 2020 December 31, 2019 Raw materials $ 48,325 $ 45,225 Work-in-process 18,949 14,581 Finished goods 110,817 104,348 $ 178,091 $ 164,154
Accrued Liabilities	Accrued liabilities and other consisted of the following (in thousands): September 30, 2020 December 31, 2019 Contingent consideration (1) $ 16,571 $ 22,953 Legal and administrative costs 14,034 11,066 Operating lease liabilities 11,941 11,110 Contract liabilities 7,723 6,728 Research and development costs 5,328 5,160 Provisions for agents, returns and other 3,772 3,922 Restructuring related liabilities (2) 1,813 4,315 Product remediation (3) 1,715 3,251 Derivative contract liabilities (4) 1,338 3,173 CRM purchase price adjustment payable to MicroPort Scientific Corporation — 14,891 Other accrued expenses 34,073 33,531 $ 98,308 $ 120,100 (1) Refer to “Note 7. Fair Value Measurements” (2) Refer to “Note 4. Restructuring” (3) Refer to “Note 5. Product Remediation Liability” (4) Refer to “ Note 9. Derivatives and Risk Management”

New Accounting Pronouncements (

New Accounting Pronouncements (Tables)	9 Months Ended
	Sep. 30, 2020
Accounting Standards Update and Change in Accounting Principle [Abstract]
Schedule of New Accounting Pronouncements and Changes in Accounting Principles	The following table provides a description of our adoption of new Accounting Standards Updates (“ASUs”) issued by the FASB and the impact of the adoption on our condensed financial statements: Issue Date & Standard Description Date of Adoption Effect on Financial Statements or Other Significant Matters June 2016 ASU No. 2016-13 The amendments in this update require a financial asset (or a group of financial assets) measured at amortized cost basis to be presented at the net amount expected to be collected. We adopted the update effective January 1, 2020 We recognized the following cumulative-effect adjustments, including to retained earnings, upon adoption at January 1, 2020: Accounts receivable, net decreased $0.6 million and accumulated deficit increased $0.6 million. January 2017 ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment This update removes step 2 of the goodwill impairment test that compares the implied fair value of goodwill with its carrying amount. Instead, an impairment test is performed by comparing the fair value of a reporting unit with its carrying amount. An impairment charge will be recorded by the amount a reporting unit’s carrying amount exceeds its fair value. January 1, 2020 There was no material impact to our consolidated financial statements as a result of adopting this ASU. August 2018 ASU No. 2018-13, Fair Value Measurement (Topic 820): Changes to the Disclosure Requirements for Fair Value Measurement This update removes, modifies and adds certain disclosure requirements related to fair value measurements. January 1, 2020 There was no material impact to our consolidated financial statements as a result of adopting this ASU. August 2018 ASU No. 2018-15, Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract This update clarifies and aligns the accounting for implementation costs for hosting arrangements with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. January 1, 2020 There was no material impact to our consolidated financial statements as a result of adopting this ASU. The following table provides a description of future adoptions of new accounting standards that may have an impact on our financial statements when adopted: Issue Date & Standard Description Projected Date of Adoption Effect on Financial Statements or Other Significant Matters August 2018 ASU No. 2018-14, Compensation—Retirement Benefits—Defined Benefit Plans—General (Subtopic 715-20): Changes to the Disclosure Requirements for Defined Benefit Plans This update adds and removes certain disclosure requirements related to defined benefit plans. This ASU is to be implemented on a retrospective basis for all periods presented with early adoption permitted. January 1, 2021 We do not expect the adoption of this update to have a material effect on our condensed consolidated financial statement disclosures.

Business Combinations - Narrati

Business Combinations - Narrative (Details) - USD ($) $ in Thousands	Jun. 12, 2019	Sep. 30, 2020	Dec. 31, 2019
Business Acquisition [Line Items]
Goodwill		$ 918,478	$ 915,794
Miami Instruments
Business Acquisition [Line Items]
Fair value of consideration transferred	$ 17,000
Cash	10,800
Contingent consideration	6,000
Goodwill	1,500
Miami Instruments | Developed technology and in process research and development
Business Acquisition [Line Items]
Intangible assets acquired	$ 14,700

Discontinued Operations (Narrat

Discontinued Operations (Narrative) (Details) - CRM Business Franchise - Discontinued Operations - USD ($) $ in Millions	Apr. 30, 2018	Mar. 31, 2020
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Consideration transferred	$ 195.9
Consideration transferred, cash	$ 9.2
Working capital adjustment		$ 16.4
Operating loss from discontinued operations		(1)
Tax benefit		$ 0.1

Restructuring Restructuring and

Restructuring Restructuring and Related Costs (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Restructuring Reserve [Roll Forward]
Charges	$ (349)	$ 698	$ 2,025	$ 4,563
Reorganization Plans
Restructuring Reserve [Roll Forward]
Balance at beginning of period			5,497
Charges			2,025
Cash payments and other			(5,672)
Balance at end of period	1,850		1,850
Reorganization Plans | Employee Severance and Other Termination Costs
Restructuring Reserve [Roll Forward]
Balance at beginning of period			4,097
Charges			2,025
Cash payments and other			(4,880)
Balance at end of period	1,242		1,242
Reorganization Plans | Other
Restructuring Reserve [Roll Forward]
Balance at beginning of period			1,400
Charges			0
Cash payments and other			(792)
Balance at end of period	$ 608		$ 608

Restructuring Restructuring Exp

Restructuring Restructuring Expense by Segment (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Restructuring Cost and Reserve [Line Items]
Charges	$ (349)	$ 698	$ 2,025	$ 4,563
Operating Segments | Cardiovascular
Restructuring Cost and Reserve [Line Items]
Charges	9	783	1,265	1,521
Operating Segments | Neuromodulation
Restructuring Cost and Reserve [Line Items]
Charges	43	(171)	851	314
Other
Restructuring Cost and Reserve [Line Items]
Charges	$ (401)	$ 86	$ (91)	$ 2,728

Product Remediation Liability_2

Product Remediation Liability (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Accrual for Environmental Loss Contingencies [Roll Forward]
Balance at beginning of period			$ 3,251
Adjustments			2,301
Remediation activity			(3,982)
Effect of changes in foreign currency exchange rates			145
Balance at end of period	$ 1,715		1,715
Product remediation expense	1,133	$ 3,076	6,868	$ 11,136
Product Liability
Product Liability Contingency [Line Items]
Litigation provision liability	$ 46,300		$ 46,300		$ 170,404

Investments (Details)

Investments (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Jun. 30, 2020	Dec. 31, 2019
Schedule of Equity Method Investments [Line Items]
Investments	$ 29,944		$ 26,805
Equity method investment	414		451
Total investments	30,358		27,256
Respicardia Inc. | Equity Method Investee | Prepaid expenses and other current assets
Schedule of Equity Method Investments [Line Items]
Outstanding loans	800		600
ALung Technologies, Inc. | Convertible Notes Receivable
Schedule of Equity Method Investments [Line Items]
Outstanding loans	2,000
Notes receivable gross		$ 2,000
Respicardia Inc.
Schedule of Equity Method Investments [Line Items]
Investments	17,706		17,706
ALung Technologies, Inc.
Schedule of Equity Method Investments [Line Items]
Investments	3,000		0
Ceribell, Inc.
Schedule of Equity Method Investments [Line Items]
Investments	3,000		3,000
ShiraTronics, Inc.
Schedule of Equity Method Investments [Line Items]
Investments	2,045		2,045
MD Start II
Schedule of Equity Method Investments [Line Items]
Investments	1,169		1,121
Rainbow Medical Ltd.
Schedule of Equity Method Investments [Line Items]
Investments	1,145		1,099
Highlife S.A.S.
Schedule of Equity Method Investments [Line Items]
Investments	1,109		1,064
Other
Schedule of Equity Method Investments [Line Items]
Investments	$ 770		$ 770

Fair Value Measurements - Asset

Fair Value Measurements - Assets and Liabilities Measured at Fair Value on a Recurring Basis (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Liabilities:
Contingent consideration	$ 79,603	$ 114,396
Capped call derivatives
Assets:
Derivative asset	39,000
Other derivatives
Liabilities:
Derivative liabilities	1,350
Derivatives Not Designated as Hedging Instruments | Embedded exchange feature
Liabilities:
Derivative liabilities	59,398
Level 1 | Other derivatives
Liabilities:
Derivative liabilities	0
Level 1 | Derivatives Not Designated as Hedging Instruments | Embedded exchange feature
Liabilities:
Derivative liabilities	0
Level 2 | Other derivatives
Liabilities:
Derivative liabilities	0
Level 2 | Derivatives Not Designated as Hedging Instruments | Embedded exchange feature
Liabilities:
Derivative liabilities	0
Level 3 | Other derivatives
Liabilities:
Derivative liabilities	1,350
Level 3 | Derivatives Not Designated as Hedging Instruments | Embedded exchange feature
Liabilities:
Derivative liabilities	59,398
Fair Value, Recurring
Assets:
Convertible notes receivable	2,301
Total assets	47,139	561
Liabilities:
Contingent consideration	96,174	137,349
Total liabilities	157,146	141,029
Fair Value, Recurring | Derivatives Designated as Hedging Instruments | Foreign Exchange Contract
Assets:
Derivative asset	1,787	535
Liabilities:
Derivative liabilities		169
Fair Value, Recurring | Derivatives Designated as Hedging Instruments | Interest rate swap contracts
Liabilities:
Derivative liabilities	139	374
Fair Value, Recurring | Derivatives Not Designated as Hedging Instruments | Foreign Exchange Contract
Assets:
Derivative asset	4,052	26
Liabilities:
Derivative liabilities	85	3,137
Fair Value, Recurring | Derivatives Not Designated as Hedging Instruments | Capped call derivatives
Assets:
Derivative asset	38,999
Fair Value, Recurring | Level 1
Assets:
Convertible notes receivable	0
Total assets	0	0
Liabilities:
Contingent consideration	0	0
Total liabilities	0	0
Fair Value, Recurring | Level 1 | Derivatives Designated as Hedging Instruments | Foreign Exchange Contract
Assets:
Derivative asset	0	0
Liabilities:
Derivative liabilities		0
Fair Value, Recurring | Level 1 | Derivatives Designated as Hedging Instruments | Interest rate swap contracts
Liabilities:
Derivative liabilities	0	0
Fair Value, Recurring | Level 1 | Derivatives Not Designated as Hedging Instruments | Foreign Exchange Contract
Assets:
Derivative asset	0	0
Liabilities:
Derivative liabilities	0	0
Fair Value, Recurring | Level 1 | Derivatives Not Designated as Hedging Instruments | Capped call derivatives
Assets:
Derivative asset	0
Fair Value, Recurring | Level 2
Assets:
Convertible notes receivable	0
Total assets	5,839	561
Liabilities:
Contingent consideration	0	0
Total liabilities	224	3,680
Fair Value, Recurring | Level 2 | Derivatives Designated as Hedging Instruments | Foreign Exchange Contract
Assets:
Derivative asset	1,787	535
Liabilities:
Derivative liabilities		169
Fair Value, Recurring | Level 2 | Derivatives Designated as Hedging Instruments | Interest rate swap contracts
Liabilities:
Derivative liabilities	139	374
Fair Value, Recurring | Level 2 | Derivatives Not Designated as Hedging Instruments | Foreign Exchange Contract
Assets:
Derivative asset	4,052	26
Liabilities:
Derivative liabilities	85	3,137
Fair Value, Recurring | Level 2 | Derivatives Not Designated as Hedging Instruments | Capped call derivatives
Assets:
Derivative asset	0
Fair Value, Recurring | Level 3
Assets:
Convertible notes receivable	2,301
Total assets	41,300	0
Liabilities:
Contingent consideration	96,174	137,349
Total liabilities	156,922	137,349
Fair Value, Recurring | Level 3 | Derivatives Designated as Hedging Instruments | Foreign Exchange Contract
Assets:
Derivative asset	0	0
Liabilities:
Derivative liabilities		0
Fair Value, Recurring | Level 3 | Derivatives Designated as Hedging Instruments | Interest rate swap contracts
Liabilities:
Derivative liabilities	0	0
Fair Value, Recurring | Level 3 | Derivatives Not Designated as Hedging Instruments | Foreign Exchange Contract
Assets:
Derivative asset	0	0
Liabilities:
Derivative liabilities	0	$ 0
Fair Value, Recurring | Level 3 | Derivatives Not Designated as Hedging Instruments | Capped call derivatives
Assets:
Derivative asset	$ 38,999

Fair Value Measurements - Conti

Fair Value Measurements - Contingent Consideration Reconciliation (Details) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2020USD ($)distributor	Sep. 30, 2020USD ($)	Sep. 30, 2019USD ($)
Liabilities Measured on Recurring Basis
Contingent consideration paid		$ 8,800
Number of distributors acquired | distributor	2
Period of delay		1 year
Remeasurement of contingent consideration to fair value		$ (31,176)	$ (2,425)
Cost of sales - exclusive of amortization
Liabilities Measured on Recurring Basis
Remeasurement of contingent consideration to fair value		19,200
Research and development
Liabilities Measured on Recurring Basis
Remeasurement of contingent consideration to fair value		12,000
Fair Value, Recurring | Level 3
Liabilities Measured on Recurring Basis
Total at beginning period		137,349
Total at period end	$ 96,174	96,174
Fair Value, Recurring | Level 3 | Embedded Exchange Feature Derivative Liability
Liabilities Measured on Recurring Basis
Total at beginning period		0
Additions		74,951
Payments		0
Changes in fair value		(15,553)
Effect of changes in foreign currency exchange rates		0
Total at period end	59,398	59,398
Less current portion at period end	0	0
Long-term portion at period end	59,398	59,398
Fair Value, Recurring | Level 3 | Other Derivative Liabilities
Liabilities Measured on Recurring Basis
Total at beginning period		0
Additions		0
Payments		0
Changes in fair value		1,350
Effect of changes in foreign currency exchange rates		0
Total at period end	1,350	1,350
Less current portion at period end	1,160	1,160
Long-term portion at period end	190	190
Fair Value, Recurring | Level 3 | Contingent Consideration Liability Arrangements
Liabilities Measured on Recurring Basis
Total at beginning period		137,349
Additions		0
Payments		(9,868)
Changes in fair value		(31,176)
Effect of changes in foreign currency exchange rates		(131)
Total at period end	96,174	96,174
Less current portion at period end	16,571	16,571
Long-term portion at period end	79,603	79,603
Fair Value, Recurring | Level 3 | Derivative Financial Instruments, Assets
Assets Measured on Recurring Basis
As of beginning period		0
Additions		43,096
Payments		0
Changes in fair value		(4,097)
Effect of changes in foreign currency exchange rates		0
Total at period end	38,999	38,999
Less current portion at period end	0	0
Long-term portion at period end	38,999	38,999
Fair Value, Recurring | Level 3 | Notes Receivable
Assets Measured on Recurring Basis
As of beginning period		0
Additions		2,267
Payments		0
Changes in fair value		34
Effect of changes in foreign currency exchange rates		0
Total at period end	2,301	2,301
Less current portion at period end	2,044	2,044
Long-term portion at period end	$ 257	$ 257

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details)	Sep. 30, 2020USD ($)	Jun. 17, 2020USD ($)
Embedded exchange feature
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
10 percent decrease in stock price volatility, fair value	$ 42,400,000
10 percent increase in stock price volatility, fair value	76,400,000
Capped call derivatives
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
10 percent decrease in stock price volatility, fair value	29,300,000
10 percent increase in stock price volatility, fair value	$ 42,300,000
Senior Notes
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Debt instrument, face amount		$ 287,500,000
2020 Cash Exchangeable Senior Notes | Senior Notes
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Debt instrument, face amount		$ 287,500,000
Measurement Input, Stock Price Volatility | Embedded exchange feature
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Derivative liability, measurement input	0.37
Measurement Input, Stock Price Volatility | Capped call derivatives
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Derivative liability, measurement input	0.37

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value of Contingent Consideration by Acquisition (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	$ 79,603	$ 114,396
Fair Value, Recurring
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	96,174	137,349
Fair Value, Recurring | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	96,174	137,349
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Liability Value	96,174	137,349
ImThera | Fair Value, Recurring | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	79,603	113,503
TandemLife | Fair Value, Recurring | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	11,672	17,311
Miami Instruments | Fair Value, Recurring | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	4,899	5,338
Drilltex | Fair Value, Recurring | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	0	294
Other | Fair Value, Recurring | Level 3
Business Acquisition, Contingent Consideration [Line Items]
Contingent consideration	$ 0	$ 903

Fair Value Measurements - Level

Fair Value Measurements - Level 3 Valuations (Details) - Level 3	Sep. 30, 2020
ImThera | Discounted cash flow | Discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.083
ImThera | Discounted cash flow | Probability of payment
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.85
ImThera | Monte Carlo simulation | Revenue volatility
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.325
ImThera | Minimum | Monte Carlo simulation | Probability of payment
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.85
ImThera | Minimum | Monte Carlo simulation | Risk-adjusted discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.122
ImThera | Minimum | Monte Carlo simulation | Credit risk discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.085
ImThera | Maximum | Monte Carlo simulation | Risk-adjusted discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.125
ImThera | Maximum | Monte Carlo simulation | Credit risk discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.092
TandemLife | Minimum | Discounted cash flow | Discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.076
TandemLife | Minimum | Discounted cash flow | Probability of payment
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.70
TandemLife | Maximum | Discounted cash flow | Discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.077
TandemLife | Maximum | Discounted cash flow | Probability of payment
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	1
Miami Instruments | Minimum | Discounted cash flow | Discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.076
Miami Instruments | Minimum | Discounted cash flow | Probability of payment
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.80
Miami Instruments | Maximum | Discounted cash flow | Discount rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.077
Miami Instruments | Maximum | Discounted cash flow | Probability of payment
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Measurement input	0.95

Financing Arrangements Schedule

Financing Arrangements Schedule of Debt (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2020	Jun. 17, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Total long-term facilities	$ 646,801		$ 333,511
Less current portion of long-term debt	9,692		73,181
Long-term debt obligations	$ 637,109		260,330
Bank of America Merrill Lynch Banco Múltiplo S.A.
Debt Instrument [Line Items]
Interest rate, stated percentage	5.61%
Mediocredito Italiano | Minimum
Debt Instrument [Line Items]
Interest rate, stated percentage	0.50%
Mediocredito Italiano | Maximum
Debt Instrument [Line Items]
Interest rate, stated percentage	2.77%
Bank of America, U.S.
Debt Instrument [Line Items]
Interest rate, stated percentage	2.08%
Secured Debt
Debt Instrument [Line Items]
Total long-term facilities	$ 422,960		0
Secured Debt | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
LIBOR floor rate	1.00%
Debt instrument, basis spread on variable rate	6.50%
Senior Notes
Debt Instrument [Line Items]
Total long-term facilities	$ 208,954		0
Interest rate, stated percentage	3.00%	3.00%
Loans Payable | Bank of America Merrill Lynch Banco Múltiplo S.A.
Debt Instrument [Line Items]
Total long-term facilities	$ 6,000		8,422
Loans Payable | Mediocredito Italiano
Debt Instrument [Line Items]
Total long-term facilities	5,835		6,222
Loans Payable | Bank of America, U.S.
Debt Instrument [Line Items]
Total long-term facilities	2,011		2,004
Loans Payable | 2019 Debt Facility
Debt Instrument [Line Items]
Total long-term facilities	0		184,275
Loans Payable | 2017 European Investment Bank
Debt Instrument [Line Items]
Total long-term facilities	0		103,570
Loans Payable | 2014 European Investment Bank
Debt Instrument [Line Items]
Total long-term facilities	0		28,053
Other
Debt Instrument [Line Items]
Total long-term facilities	$ 1,041		$ 965

Financing Arrangements - Narrat

Financing Arrangements - Narrative (Details)	Jun. 17, 2020USD ($)$ / shares	Jun. 10, 2020USD ($)	Sep. 30, 2020USD ($)claim$ / shares	Sep. 30, 2020USD ($)claim$ / shares	Sep. 30, 2019USD ($)	Dec. 31, 2019USD ($)
Debt Instrument [Line Items]
Proceeds from long-term debt obligations				$ 886,899,000	$ 193,490,000
Minimum pro rata net revenue				550,000,000
Repayments of debt			$ 528,000,000
Loss on debt extinguishment				$ 1,400,000
Capped call derivatives
Debt Instrument [Line Items]
Derivative, cap price per share | $ / shares			$ 100	$ 100
Derivative, cost of hedge				$ 43,100,000
Derivative asset			$ 39,000,000	$ 39,000,000
Senior Notes
Debt Instrument [Line Items]
Interest rate (percent)			9.90%	9.90%
Debt instrument, face amount	$ 287,500,000
Proceeds from long-term debt obligations	278,000,000
Debt discounts and issuance costs	$ 82,000,000
Amortization of Debt Issuance Costs			$ 3,000,000	$ 3,400,000
Interest rate, stated percentage	3.00%		3.00%	3.00%
Unamortized discount	$ 75,000,000
Debt issuance costs, net	$ 7,000,000
Debt instrument, exchangeable, conversion ratio			0.016398
Option to exchange, price per share | $ / shares	$ 60.98
Redemption price, percentage of exchange price				130.00%
Redemption, threshold trading days | claim			20	20
Redemption, threshold consecutive trading days | claim			30	30
Redemption price, percentage				100.00%
Fair value of embedded derivative liability			$ 59,400,000	$ 59,400,000
Secured Debt
Debt Instrument [Line Items]
Interest rate (percent)			9.00%	9.00%
Debt instrument, face amount		$ 450,000,000
Long-term debt, term		5 years
Proceeds from long-term debt obligations		$ 421,700,000
Minimum net revenue				$ 700,000,000
Debt discounts and issuance costs		$ 28,300,000
Amortization of Debt Issuance Costs			$ 1,100,000	$ 1,300,000
Secured Debt | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
LIBOR floor rate			1.00%	1.00%
Debt instrument, basis spread on variable rate				6.50%
Revolving Credit Facility
Debt Instrument [Line Items]
Short-term debt			$ 4,300,000	$ 4,300,000		$ 4,200,000
Minimum | Revolving Credit Facility
Debt Instrument [Line Items]
Interest rate (percent)			3.21%	3.21%
Maximum | Revolving Credit Facility
Debt Instrument [Line Items]
Interest rate (percent)			7.20%	7.20%
Debt instrument, term				10 months

Financing Arrangements - Levera

Financing Arrangements - Leverage Ratios (Details)	Sep. 30, 2020
Debt Disclosure [Abstract]
Secured leverage ratio, period one	5.625
Secured leverage ratio, period two	4.5

Derivatives and Risk Manageme_3

Derivatives and Risk Management Narrative (Details) - Foreign Exchange Contract - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Foreign exchange and other gains (losses)
Derivative [Line Items]
Gain (loss) on derivative	$ (11.7)	$ 3.1	$ (4.8)	$ 6.8
Derivatives Not Designated as Hedging Instruments
Derivative [Line Items]
Notional amount	$ 332.2		$ 332.2		$ 338

Derivatives and Risk Manageme_4

Derivatives and Risk Management Derivative Notional Amounts (Details) - Derivatives Designated as Hedging Instruments - Cash Flow Hedging - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Derivative [Line Items]
Notional amount	$ 60,186	$ 106,750
Foreign Exchange Contract | United Kingdom, Pounds
Derivative [Line Items]
Notional amount	7,610	10,128
Foreign Exchange Contract | Japan, Yen
Derivative [Line Items]
Notional amount	16,023	25,342
Foreign Exchange Contract | Euro Member Countries, Euro
Derivative [Line Items]
Notional amount	36,553	48,838
Interest Rate Swap Contracts
Derivative [Line Items]
Notional amount	$ 0	$ 22,442

Derivatives and Risk Manageme_5

Derivatives and Risk Management Amount of Gain (Loss) Recognized in OCI and Income Statement (Details) - Cash Flow Hedging - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Derivative Instruments, Gain (Loss) [Line Items]
Gains (Losses) Recognized in OCI	$ 1,482	$ (689)	$ 632	$ 933
Gains (Losses) Reclassified from AOCI to Earnings	(158)	181	(681)	1,598
Foreign Exchange Contract | Foreign exchange and other gains (losses)
Derivative Instruments, Gain (Loss) [Line Items]
Gains (Losses) Recognized in OCI	1,482	(689)	632	933
Gains (Losses) Reclassified from AOCI to Earnings	(692)	963	(777)	3,094
Foreign Exchange Contract | SG&A
Derivative Instruments, Gain (Loss) [Line Items]
Gains (Losses) Recognized in OCI	0	0	0	0
Gains (Losses) Reclassified from AOCI to Earnings	$ 534	(742)	209	(1,470)
Interest Rate Swap Contracts | Interest expense
Derivative Instruments, Gain (Loss) [Line Items]
Gains (Losses) Recognized in OCI		0	0	0
Gains (Losses) Reclassified from AOCI to Earnings		$ (40)	(113)	$ (26)
Derivatives Designated as Hedging Instruments | Foreign Exchange Contract
Derivative Instruments, Gain (Loss) [Line Items]
After-Tax Net Loss in AOCI as of period end			1,512
Amount Expected to be Reclassified to Earnings in Next 12 Months			$ 1,512

Derivatives and Risk Manageme_6

Derivatives and Risk Management Fair Value of Derivative Instruments (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Derivatives, Fair Value [Line Items]
Total asset derivatives	$ 44,838	$ 561
Total liability derivatives	60,972	3,680
Derivatives Designated as Hedging Instruments
Derivatives, Fair Value [Line Items]
Total asset derivatives	1,787	535
Total liability derivatives		543
Derivatives Designated as Hedging Instruments | Prepaid expenses and other current assets | Foreign Exchange Contract
Derivatives, Fair Value [Line Items]
Total asset derivatives	1,775	148
Derivatives Designated as Hedging Instruments | Accrued liabilities | Interest rate swap contracts
Derivatives, Fair Value [Line Items]
Total liability derivatives		313
Derivatives Designated as Hedging Instruments | Accrued liabilities | Foreign Exchange Contract
Derivatives, Fair Value [Line Items]
Total asset derivatives	12	387
Total liability derivatives		169
Derivatives Designated as Hedging Instruments | Long-term derivative liability | Interest rate swap contracts
Derivatives, Fair Value [Line Items]
Total liability derivatives		61
Derivatives Not Designated as Hedging Instruments
Derivatives, Fair Value [Line Items]
Total asset derivatives	43,051	26
Total liability derivatives	60,972	3,137
Derivatives Not Designated as Hedging Instruments | Prepaid expenses and other current assets | Foreign Exchange Contract
Derivatives, Fair Value [Line Items]
Total asset derivatives	4,052
Total liability derivatives	34	33
Derivatives Not Designated as Hedging Instruments | Accrued liabilities | Interest rate swap contracts
Derivatives, Fair Value [Line Items]
Total liability derivatives	139
Derivatives Not Designated as Hedging Instruments | Accrued liabilities | Foreign Exchange Contract
Derivatives, Fair Value [Line Items]
Total asset derivatives		26
Total liability derivatives	51	$ 3,104
Derivatives Not Designated as Hedging Instruments | Accrued liabilities | Other derivatives
Derivatives, Fair Value [Line Items]
Total liability derivatives	1,160
Derivatives Not Designated as Hedging Instruments | Long-term derivative liability | Embedded exchange feature
Derivatives, Fair Value [Line Items]
Total liability derivatives	59,398
Derivatives Not Designated as Hedging Instruments | Long-term derivative liability | Other derivatives
Derivatives, Fair Value [Line Items]
Total liability derivatives	190
Derivatives Not Designated as Hedging Instruments | Other assets | Capped call derivatives
Derivatives, Fair Value [Line Items]
Total asset derivatives	$ 38,999

Commitments and Contingencies -

Commitments and Contingencies - Narrative (Details) € in Thousands	Sep. 30, 2020USD ($)noticeinstallment	Mar. 29, 2019USD ($)	Apr. 01, 2016EUR (€)	Jan. 31, 2020USD ($)	Jul. 31, 2019USD ($)	Jan. 31, 2012USD ($)	Sep. 30, 2020USD ($)noticeinstallment	Sep. 30, 2020EUR (€)	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)noticeinstallment	Sep. 30, 2019USD ($)	Oct. 29, 2020claim	Sep. 30, 2020EUR (€)noticeinstallment	Dec. 31, 2019USD ($)	May 31, 2019EUR (€)	Mar. 05, 2019EUR (€)	Aug. 27, 2015non-conformity
Other Commitments [Line Items]
Product remediation	$ 1,715,000						$ 1,715,000			$ 1,715,000				$ 3,251,000
Income tax (benefit) expense							(3,990,000)		$ (10,653,000)	17,581,000	$ (23,431,000)
Regional Internal Revenue Office of Lombardy
Other Commitments [Line Items]
Application pending approval, payments for legal settlements | €															€ 1,900
Unrecognized tax benefits, net of settlement payment | €													€ 15,500
Income tax (benefit) expense							6,500,000	€ 5,400
Deferred tax asset	11,800,000						11,800,000			11,800,000			10,100
Threatened Litigation | Regional Internal Revenue Office of Lombardy
Other Commitments [Line Items]
Losses under dispute	$ 73,200,000						$ 73,200,000			$ 73,200,000			€ 62,600
Number of equal installments | installment	5						5			5			5
Number of notice of assessments | notice	3						3			3			3
Pending Litigation
Other Commitments [Line Items]
Estimate of possible loss	$ 669,100,000						$ 669,100,000			$ 669,100,000						€ 572,100
Subsequent Event
Other Commitments [Line Items]
Pending claims, number | claim												85
FDA Warning Letter
Other Commitments [Line Items]
Number of observed non-conformities | non-conformity																	2
Product Liability
Other Commitments [Line Items]
Payments for legal settlements				$ 90,000,000	$ 135,000,000
Litigation provision liability	46,300,000						$ 46,300,000			$ 46,300,000				$ 170,404,000
Product Liability | Maximum
Other Commitments [Line Items]
Litigation settlement, amount awarded to other party		$ 225,000,000
SNIA
Other Commitments [Line Items]
Reimbursed legal fees	$ 342,000		€ 292
SNIA | Pending Litigation | SNIA s.p.a
Other Commitments [Line Items]
Compensation sought						$ 4,000,000,000

Commitments and Contingencies_2

Commitments and Contingencies - Schedule of Product Liability (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2020	Dec. 31, 2019
Litigation Provision Liability
Less current portion of litigation liability at period end	$ 34,790	$ 146,026
Long-term portion of litigation provisions liability at period end	11,510
Product Liability
Litigation Provision Liability
Total litigation provision liability at beginning of period	170,404
Payments	(128,128)
Adjustments	3,970
FX and other	54
Total litigation provision liability at end of period	46,300
Less current portion of litigation liability at period end	34,790
Long-term portion of litigation provisions liability at period end	$ 11,510

Stockholders' Equity Statement

Stockholders' Equity Statement of Stockholders' Equity (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning Balance (in shares)			49,411,016
Beginning Balance	$ 1,333,186	$ 1,483,328	$ 1,383,717	$ 1,503,738
Stock-based compensation plans	$ 7,674	8,272	$ 23,889	20,624
Cancellation of shares (in shares)	(73,000)		(73,000)
Net loss	$ (14,772)	32,118	$ (65,182)	(11,946)
Other comprehensive income	$ 24,704	(28,436)	$ 9,007	(17,134)
Ending Balance (in shares)	49,402,628		49,402,628
Ending Balance	$ 1,350,792	$ 1,495,282	$ 1,350,792	$ 1,495,282
Accounting Standards Update [Extensible List]			us-gaap:AccountingStandardsUpdate201613Member	us-gaap:AccountingStandardsUpdate201613Member
Cumulative Effect, Period of Adoption, Adjustment
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning Balance			$ (639)
Ordinary Shares
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning Balance (in shares)	49,476,000	49,380,000	49,411,000	49,323,000
Beginning Balance	$ 76,338	$ 76,217	$ 76,257	$ 76,144
Stock-based compensation plans (in shares)		1,000	65,000	58,000
Stock-based compensation plans			$ 81	$ 73
Ending Balance (in shares)	49,403,000	49,381,000	49,403,000	49,381,000
Ending Balance	$ 76,338	$ 76,217	$ 76,338	$ 76,217
Additional Paid-In Capital
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning Balance	1,750,798	1,717,220	1,734,870	1,705,111
Stock-based compensation plans	7,670	8,262	23,598	20,371
Ending Balance	1,758,468	1,725,482	1,758,468	1,725,482
Treasury Stock
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning Balance	(1,057)	(1,292)	(1,263)	(1,462)
Stock-based compensation plans	4	10	210	180
Ending Balance	(1,053)	(1,282)	(1,053)	(1,282)
Accumulated Other Comprehensive Loss
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning Balance	(35,089)	(13,174)	(19,392)	(24,476)
Other comprehensive income	24,704	(28,436)	9,007	(17,134)
Ending Balance	(10,385)	(41,610)	(10,385)	(41,610)
Accumulated Deficit
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning Balance	(457,804)	(295,643)	(406,755)	(251,579)
Net loss	(14,772)	32,118	(65,182)	(11,946)
Ending Balance	$ (472,576)	$ (263,525)	(472,576)	$ (263,525)
Accumulated Deficit | Cumulative Effect, Period of Adoption, Adjustment
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Beginning Balance			$ (639)

Stockholders' Equity (Comprehen

Stockholders' Equity (Comprehensive Income) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning Balance	$ 1,333,186	$ 1,483,328	$ 1,383,717	$ 1,503,738
Other comprehensive income before reclassifications, before tax			8,640	(15,695)
Tax expense			(152)	(224)
Other comprehensive income before reclassifications, net of tax			8,488	(15,919)
Reclassification of loss from accumulated other comprehensive loss, before tax			681	(1,598)
Reclassification of tax benefit			(162)	383
Reclassification of loss from accumulated other comprehensive loss, after tax			519	(1,215)
Total other comprehensive income (loss)	24,704	(28,436)	9,007	(17,134)
Ending Balance	1,350,792	1,495,282	1,350,792	1,495,282
Total
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning Balance	(35,089)	(13,174)	(19,392)	(24,476)
Total other comprehensive income (loss)	24,704	(28,436)	9,007	(17,134)
Ending Balance	(10,385)	(41,610)	(10,385)	(41,610)
Change in Unrealized Gain (Loss) on Derivatives
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning Balance			513	(944)
Other comprehensive income before reclassifications, before tax			632	933
Tax expense			(152)	(224)
Other comprehensive income before reclassifications, net of tax			480	709
Reclassification of loss from accumulated other comprehensive loss, before tax			681	(1,598)
Reclassification of tax benefit			(162)	383
Reclassification of loss from accumulated other comprehensive loss, after tax			519	(1,215)
Total other comprehensive income (loss)			999	(506)
Ending Balance	1,512	(1,450)	1,512	(1,450)
Foreign Currency Translation Adjustments Gain (Loss)
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning Balance			(19,905)	(23,532)
Other comprehensive income before reclassifications, before tax			8,008	(16,628)
Tax expense			0	0
Other comprehensive income before reclassifications, net of tax			8,008	(16,628)
Reclassification of loss from accumulated other comprehensive loss, before tax			0	0
Reclassification of tax benefit			0	0
Reclassification of loss from accumulated other comprehensive loss, after tax			0	0
Total other comprehensive income (loss)			8,008	(16,628)
Ending Balance	$ (11,897)	$ (40,160)	$ (11,897)	$ (40,160)

Stock-Based Incentive Plans (Co

Stock-Based Incentive Plans (Compensation Expense) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 7,810	$ 8,531	$ 26,845	$ 24,127
Share-based compensation arrangement, vesting period			4 years
Share-based compensation arrangement, compensation cost	3,300		$ 6,600
Service-based restricted stock units (“RSUs”)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	4,410	3,583	13,139	10,428
Service-based stock appreciation rights (“SARs”)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	3,211	2,896	9,185	7,804
Market performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 814	757	$ 2,745	2,146
Share-based compensation arrangement, vesting period	3 years		3 years
Operating performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ (962)	983	$ 882	2,752
Share-based compensation arrangement, vesting period			3 years
Employee share purchase plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 337	$ 312	$ 894	$ 997

Stock-Based Incentive Plans (Ex

Stock-Based Incentive Plans (Executed Agreements) (Details) shares in Thousands	9 Months Ended
	Sep. 30, 2020$ / sharesshares
Service-based stock appreciation rights (“SARs”)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares (in shares) | shares	1,133
Weighted average grant date fair value (in dollars per share) | $ / shares	$ 15.73
Service-based restricted stock units (“RSUs”)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares (in shares) | shares	599
Weighted average grant date fair value (in dollars per share) | $ / shares	$ 44.42
Market performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares (in shares) | shares	93
Weighted average grant date fair value (in dollars per share) | $ / shares	$ 39.83
Operating performance-based restricted stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares (in shares) | shares	93
Weighted average grant date fair value (in dollars per share) | $ / shares	$ 43.57

Income Taxes Narrative (Details

Income Taxes Narrative (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Effective tax rate (percent)	21.30%	(49.60%)	(37.90%)	65.90%
Valuation allowance	$ 74.5		$ 74.5
Tax benefit, CARES Act			42.4
Unrecognized tax benefits	4		4		$ 12.9
Unrecognized tax benefits, potential decrease amount	$ 0.7		$ 0.7

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Earnings Per Share, Basic and Diluted (Details) - shares shares in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Earnings Per Share [Abstract]
Basic weighted average shares outstanding (in shares)	48,652	48,395	48,582	48,329
Add effects of share-based compensation instruments (in shares)	0	425	0	0
Diluted weighted average shares outstanding (in shares)	48,652	48,820	48,582	48,329

Earnings Per Share - Narrative

Earnings Per Share - Narrative (Details) - shares shares in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Stock Compensation Plan
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share amount (in shares)	4.1	1.4	4.2	3.2

Geographic and Segment Inform_3

Geographic and Segment Information Segment Info (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020USD ($)geographic_region	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)segmentgeographic_region	Sep. 30, 2019USD ($)	Dec. 31, 2019USD ($)
Segment Reporting Information [Line Items]
Reportable segments | segment			2
Number of geographic regions in which entity operates | geographic_region	3		3
Net sales	$ 240,083	$ 268,610	$ 664,686	$ 796,580
Merger and integration expenses	1,094	6,716	6,616	14,345
Restructuring expenses	(349)	698	2,025	4,563
Amortization of intangibles	9,685	11,146	29,346	29,690
Operating (loss) income from continuing operations	(7,508)	25,761	(22,137)	(24,894)
Interest income	47	151	482	624
Interest expense	(14,673)	(4,774)	(25,237)	(10,490)
Foreign exchange and other gains (losses)	3,420	327	507	(795)
(Loss) income from continuing operations before tax	(18,714)	21,465	(46,385)	(35,555)
Assets	2,521,748		2,521,748		$ 2,411,797
Operating Segments | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	140,878	155,426	417,482	483,161
Restructuring expenses	9	783	1,265	1,521
Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net sales	98,408	112,543	245,277	311,461
Restructuring expenses	43	(171)	851	314
Other
Segment Reporting Information [Line Items]
Net sales	797	641	1,927	1,958
Restructuring expenses	(401)	86	(91)	2,728
Continuing Operations
Segment Reporting Information [Line Items]
Total reportable segment income from continuing operations	2,922	44,321	15,850	23,704
Merger and integration expenses	1,094	6,716	6,616	14,345
Restructuring expenses	(349)	698	2,025	4,563
Amortization of intangibles	9,685	11,146	29,346	29,690
Operating (loss) income from continuing operations	(7,508)	25,761	(22,137)	(24,894)
Capital expenditures	9,217	6,005	28,236	16,801
Continuing Operations | Operating Segments | Cardiovascular
Segment Reporting Information [Line Items]
Total reportable segment income from continuing operations	(7,311)	36,180	(8,037)	47,289
Assets	1,463,523		1,463,523		1,546,520
Capital expenditures	7,040	5,178	17,777	13,564
Continuing Operations | Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Total reportable segment income from continuing operations	21,154	30,010	82,294	52,260
Assets	668,899		668,899		749,069
Capital expenditures	1,210	136	7,285	666
Continuing Operations | Other
Segment Reporting Information [Line Items]
Total reportable segment income from continuing operations	(10,921)	(21,869)	(58,407)	(75,845)
Assets	389,326		389,326		$ 116,208
Capital expenditures	967	691	3,174	2,571
United States
Segment Reporting Information [Line Items]
Net sales	128,863	138,426	330,633	401,400
United States | Operating Segments | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	49,009	49,993	133,288	155,530
United States | Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net sales	79,854	88,433	197,345	245,870
Europe
Segment Reporting Information [Line Items]
Net sales	48,529	50,235	138,606	165,267
Europe | Operating Segments | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	38,054	39,810	111,132	131,187
Europe | Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net sales	10,475	10,425	27,474	34,080
Rest of World
Segment Reporting Information [Line Items]
Net sales	62,691	79,949	195,447	229,913
Rest of World | Operating Segments | Cardiovascular
Segment Reporting Information [Line Items]
Net sales	53,815	65,623	173,062	196,444
Rest of World | Operating Segments | Neuromodulation
Segment Reporting Information [Line Items]
Net sales	8,079	13,685	20,458	31,511
Cardiopulmonary
Segment Reporting Information [Line Items]
Net sales	107,200	120,014	324,623	372,163
Cardiopulmonary | United States
Segment Reporting Information [Line Items]
Net sales	33,549	39,054	96,223	119,580
Cardiopulmonary | Europe
Segment Reporting Information [Line Items]
Net sales	29,947	30,052	87,475	99,933
Cardiopulmonary | Rest of World
Segment Reporting Information [Line Items]
Net sales	43,704	50,908	140,925	152,650
Heart Valves
Segment Reporting Information [Line Items]
Net sales	21,136	28,877	63,813	87,901
Heart Valves | United States
Segment Reporting Information [Line Items]
Net sales	3,129	4,626	8,990	13,660
Heart Valves | Europe
Segment Reporting Information [Line Items]
Net sales	7,945	9,572	22,822	30,757
Heart Valves | Rest of World
Segment Reporting Information [Line Items]
Net sales	10,062	14,679	32,001	43,484
Advanced Circulatory Support
Segment Reporting Information [Line Items]
Net sales	12,542	6,535	29,046	23,097
Advanced Circulatory Support | United States
Segment Reporting Information [Line Items]
Net sales	12,331	6,313	28,075	22,290
Advanced Circulatory Support | Europe
Segment Reporting Information [Line Items]
Net sales	162	186	835	497
Advanced Circulatory Support | Rest of World
Segment Reporting Information [Line Items]
Net sales	$ 49	$ 36	$ 136	$ 310

Geographic and Segment Inform_4

Geographic and Segment Information Changes in Carrying Amount of Goodwill (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2020USD ($)
Goodwill
Goodwill, beginning	$ 915,794
Foreign currency adjustments	2,684
Goodwill, ending	918,478
Neuromodulation
Goodwill
Goodwill, beginning	398,754
Foreign currency adjustments	0
Goodwill, ending	398,754
Cardiovascular
Goodwill
Goodwill, beginning	517,040
Foreign currency adjustments	2,684
Goodwill, ending	$ 519,724

Geographic and Segment Inform_5

Geographic and Segment Information Geographic Areas (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Segment Reporting Information [Line Items]
Property, plant and equipment, net	$ 190,509	$ 181,354
United States
Segment Reporting Information [Line Items]
Property, plant and equipment, net	64,620	61,410
Europe
Segment Reporting Information [Line Items]
Property, plant and equipment, net	116,746	110,270
Rest of World
Segment Reporting Information [Line Items]
Property, plant and equipment, net	$ 9,143	$ 9,674

Supplemental Financial Inform_3

Supplemental Financial Information (Summary of Inventory) (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Balance Sheet Related Disclosures [Abstract]
Raw materials	$ 48,325	$ 45,225
Work-in-process	18,949	14,581
Finished goods	110,817	104,348
Inventory, Net	178,091	164,154
Provision for obsolescence	$ 14,500	$ 12,700

Supplemental Financial Inform_4

Supplemental Financial Information (Summary of Accrued Liabilities) (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Balance Sheet Related Disclosures [Abstract]
Contingent consideration	$ 16,571	$ 22,953
Legal and administrative costs	14,034	11,066
Operating lease liabilities	11,941	11,110
Contract liabilities	7,723	6,728
Research and development costs	5,328	5,160
Provisions for agents, returns and other	3,772	3,922
Restructuring related liabilities	1,813	4,315
Product remediation	1,715	3,251
Derivative contract liabilities	1,338	3,173
CRM purchase price adjustment payable to MicroPort Scientific Corporation	0	14,891
Other accrued expenses	34,073	33,531
Accrued liabilities	98,308	120,100
Contract liability	$ 9,500	$ 8,600

New Accounting Pronouncements_2

New Accounting Pronouncements (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Jun. 30, 2020	Jan. 01, 2020	Dec. 31, 2019	Jun. 30, 2019	Dec. 31, 2018
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Increase (decrease) in accounts receivable	$ 191,892			$ 600	$ 257,769
Stockholders' Equity Attributable to Parent	$ (1,350,792)	$ (1,495,282)	$ (1,333,186)		(1,383,717)	$ (1,483,328)	$ (1,503,738)
Accounting Standards Update [Extensible List]	us-gaap:AccountingStandardsUpdate201613Member	us-gaap:AccountingStandardsUpdate201613Member
Retained Earnings
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Stockholders' Equity Attributable to Parent	$ 472,576	$ 263,525	$ 457,804	$ (600)	$ 406,755	$ 295,643	$ 251,579