Organogenesis (ORGO) 10-Q 12 Nov 19 2019 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2019	Nov. 01, 2019
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q3
Entity Registrant Name	Organogenesis Holdings Inc.
Entity Central Index Key	0001661181
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Trading Symbol	ORGO
Entity Small Business	false
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Address, State or Province	MA
Entity Shell Company	false
Title of 12(b) Security	Class A Common Stock
Security Exchange Name	NASDAQ
Entity Common Stock, Shares Outstanding		94,743,312

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Current assets:
Cash	$ 22,974	$ 21,291
Restricted cash	185	114
Accounts receivable, net	34,383	34,077
Inventory	20,184	13,321
Prepaid expenses and other current assets	3,117	2,328
Total current assets	80,843	71,131
Property and equipment, net	44,254	39,623
Notes receivable from related parties	536	477
Intangible assets, net	22,314	26,091
Goodwill	25,539	25,539
Deferred tax asset	238	238
Other assets	916	579
Total assets	174,640	163,678
Current liabilities:
Deferred acquisition consideration	5,000	5,000
Redeemable common stock liability		6,762
Current portion of notes payable		2,545
Current portion of capital lease obligations	2,872	2,236
Accounts payable	28,251	19,165
Accrued expenses and other current liabilities	20,606	20,388
Total current liabilities	56,729	56,096
Line of credit	33,484	26,484
Notes payable, net of current portion		12,578
Term loan	49,599
Deferred rent	736	130
Capital lease obligations, net of current portion	14,893	15,418
Other liabilities	6,391	5,931
Total liabilities	161,832	116,637
Commitments and contingencies (Note 13)
Stockholders' equity (deficit):
Common stock, $0.0001 par value; 400,000,000 shares authorized; 95,470,290 and 91,261,413 shares issued; 94,741,742 and 91,261,413 shares outstanding at September 30, 2019 and December 31, 2018, respectively	9	9
Additional paid-in capital	179,408	177,272
Accumulated deficit	(166,609)	(130,240)
Total stockholders' equity	12,808	47,041
Total liabilities and stockholders' equity	$ 174,640	$ 163,678

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Sep. 30, 2019	Dec. 31, 2018
Common stock, par value	$ 0.0001	$ 0.0001
Common stock, shares authorized	400,000,000	400,000,000
Common stock, shares issued	95,470,290	91,261,413
Common stock, shares outstanding	94,741,742	91,261,413

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Income Statement [Abstract]
Net revenue	$ 64,265	$ 50,769	$ 186,336	$ 129,850
Cost of goods sold	19,131	19,477	55,557	51,298
Gross profit	45,134	31,292	130,779	78,552
Operating expenses:
Selling, general and administrative	49,475	38,583	147,325	114,483
Research and development	3,924	2,779	11,159	7,651
Write-off of deferred offering costs				3,494
Total operating expenses	53,399	41,362	158,484	125,628
Loss from operations	(8,265)	(10,070)	(27,705)	(47,076)
Other income (expense), net:
Interest expense, net	(2,427)	(2,940)	(6,392)	(8,131)
Change in fair value of warrants		(50)		(299)
Loss on the extinguishment of debt			(1,862)
Other income (expense), net	(1)	9	11	12
Total other income (expense), net	(2,428)	(2,981)	(8,243)	(8,418)
Net loss before income taxes	(10,693)	(13,051)	(35,948)	(55,494)
Income tax expense	(48)	(27)	(108)	(82)
Net loss	(10,741)	$ (13,078)	(36,056)	$ (55,576)
Non-cash deemed dividend to warrant holders	(645)		645
Net loss attributed to common shareholders	$ (11,386)		$ (36,701)
Net loss per share attributed to common shareholders—basic and diluted	$ (0.12)	$ (0.19)	$ (0.40)	$ (0.83)
Weighted average common shares outstanding—basic and diluted	92,276,858	69,496,280	91,182,233	66,745,895

CONSOLIDATED STATEMENTS OF REDE

CONSOLIDATED STATEMENTS OF REDEEMABLE COMMON STOCK AND STOCKHOLDERS' EQUITY (DEFICIT) - USD ($) $ in Thousands	Total	Redeemable Common Stock	Common Stock	Additional Paid-in Capital	Accumulated Deficit
Balance at Dec. 31, 2017	$ (15,317)	$ 6,762	$ 6	$ 50,086	$ (65,409)
Balance (in shares) at Dec. 31, 2017		728,548	66,983,139
Proceeds from equity financing, net of issuance costs of $270	45,730		$ 1	45,729
Proceeds from equity financing, net of issuance costs of $270 (in shares)			6,538,732
Exercise of stock options	111			111
Exercise of stock options (in shares)			73,257
Stock-based compensation expense	820			820
Net loss	(55,576)				(55,576)
Balance at Sep. 30, 2018	(24,232)	$ 6,762	$ 7	96,746	(120,985)
Balance (in shares) at Sep. 30, 2018		728,548	73,595,128
Balance at Dec. 31, 2017	(15,317)	$ 6,762	$ 6	50,086	(65,409)
Balance (in shares) at Dec. 31, 2017		728,548	66,983,139
Balance at Dec. 31, 2018	$ 47,041		$ 9	177,272	(130,240)
Balance (in shares) at Dec. 31, 2018	91,261,413	728,548	91,261,413
Balance at Jun. 30, 2018	$ (57,169)	$ 6,762	$ 6	50,732	(107,907)
Balance (in shares) at Jun. 30, 2018		728,548	67,040,639
Proceeds from equity financing, net of issuance costs of $270	45,730		$ 1	45,729
Proceeds from equity financing, net of issuance costs of $270 (in shares)			6,538,732
Exercise of stock options	33			33
Exercise of stock options (in shares)			15,757
Stock-based compensation expense	252			252
Net loss	(13,078)				(13,078)
Balance at Sep. 30, 2018	(24,232)	$ 6,762	$ 7	96,746	(120,985)
Balance (in shares) at Sep. 30, 2018		728,548	73,595,128
Balance at Dec. 31, 2018	$ 47,041		$ 9	177,272	(130,240)
Balance (in shares) at Dec. 31, 2018	91,261,413	728,548	91,261,413
Adoption of ASC 606	$ 332				332
Exercise of common stock warrants	628			628
Exercise of common stock warrants (in shares)			74,052
Exercise of stock options	$ 163			163
Exercise of stock options (in shares)	91,045		91,045
Common stock issued in warrant exchange				645	(645)
Common stock issued in warrant exchange (shares)			3,315,232
Stock-based compensation expense	$ 700			700
Redemption of redeemable common stock placed into treasury (in shares)		(728,548)
Net loss	(36,056)				(36,056)
Balance at Sep. 30, 2019	$ 12,808		$ 9	179,408	(166,609)
Balance (in shares) at Sep. 30, 2019	94,741,742		94,741,742
Balance at Jun. 30, 2019	$ 23,198	$ 0	$ 9	178,412	(155,223)
Balance (in shares) at Jun. 30, 2019		0	91,342,722
Exercise of common stock warrants (in shares)			19,426
Exercise of stock options	109			109
Exercise of stock options (in shares)			64,362
Common stock issued in warrant exchange				645	(645)
Common stock issued in warrant exchange (shares)			3,315,232
Stock-based compensation expense	242			242
Net loss	(10,741)				(10,741)
Balance at Sep. 30, 2019	$ 12,808		$ 9	$ 179,408	$ (166,609)
Balance (in shares) at Sep. 30, 2019	94,741,742		94,741,742

CONSOLIDATED STATEMENTS OF RE_2

CONSOLIDATED STATEMENTS OF REDEEMABLE COMMON STOCK AND STOCKHOLDERS' EQUITY (DEFICIT) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2018
Issuance costs	$ 270	$ 270

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Cash flows from operating activities:
Net loss	$ (36,056)	$ (55,576)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation	2,553	2,608
Amortization of intangible assets	4,526	2,752
Non-cash interest expense, net	196	595
Deferred interest expense	974	179
Deferred rent expense	606	42
Gain on disposal of property and equipment		(1)
Write-off of deferred offering costs		3,494
Benefit recorded for sales returns and doubtful accounts	(29)	(18)
Provision recorded for inventory reserve	809	2,068
Stock-based compensation	700	820
Change in fair value of warrant liability		299
Loss on extinguishment of debt	1,862
Changes in fair value of forfeiture rights		589
Changes in operating assets and liabilities:
Accounts receivable	553	(815)
Inventory	(7,840)	145
Prepaid expenses and other current assets	(699)	(2,665)
Accounts payable	5,348	(508)
Accrued expenses and other current liabilities	85	(675)
Accrued interest—affiliate debt		2,859
Other liabilities	(715)	578
Net cash used in operating activities	(27,127)	(43,230)
Cash flows from investing activities:
Purchases of property and equipment	(2,526)	(1,495)
Proceeds from disposal of property and equipment		1
Acquisition of intangible asset	(250)
Net cash used in investing activities	(2,776)	(1,494)
Cash flows from financing activities:
Line of credit borrowings	7,000	2,616
Proceeds from term loan	50,000
Proceeds from long—term debt—affiliates		15,000
Proceeds from notes payable		5,000
Proceeds from equity financing		46,000
Repayment of notes payable	(17,585)	(10)
Proceeds from the exercise of stock options	163	111
Proceeds from the exercise of common stock warrants	628
Redemption of redeemable common stock placed into treasury	(6,762)
Principal repayments of capital lease obligations	(863)	(17)
Payment of debt issuance costs	(924)	(177)
Payment of equity issuance costs		(270)
Net cash provided by financing activities	31,657	68,253
Change in cash and restricted cash	1,754	23,529
Cash and restricted cash, beginning of period	21,405	2,358
Cash and restricted cash, end of period	23,159	25,887
Supplemental disclosure of cash flow information:
Cash paid for interest	5,922	3,812
Cash paid for income taxes	110	62
Supplemental disclosure of non-cash investing and financing activities:
Non-cash deemed dividend related to warrant exchange	645
Debt and equity issuance costs included in accounts payable	91
Purchases of property and equipment included in accounts payable and accrued expenses	3,698	$ 39
Equipment acquired under capital lease	973
Acquisition of intangible assets included in accrued expenses and other liabilities	$ 500

Nature of the Business and Basi

Nature of the Business and Basis of Presentation	9 Months Ended
	Sep. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of the Business and Basis of Presentation	1. Nature of the Business and Basis of Presentation Organogenesis Holdings Inc. (formerly Avista Healthcare Public Acquisition Corp.) (“ORGO” or the “Company”) is a leading regenerative medicine company focused on the development, manufacture, and commercialization of solutions for the Advanced Wound Care and Surgical & Sports Medicine markets. The majority of the existing and pipeline products in the Company’s portfolio have Premarket Application approval, Business License Applicant approval or Premarket Notification 510(k) clearance from the United States Food and Drug Administration (“FDA”). The Company’s customers include hospitals, wound care centers, government facilities, ambulatory service centers (ASCs) and physician offices. The Company operates in one operating and reportable segment. Merger with Avista Healthcare Public Acquisition Corp On December 10, 2018, Avista Healthcare Public Acquisition Corp., our predecessor company (“AHPAC”), consummated the previously announced merger (the “Avista Merger”) pursuant to an Agreement and Plan of Merger, dated as of August 17, 2018 (as amended, the “Avista Merger Agreement”), by and among AHPAC, Avista Healthcare Merger Sub, Inc., a Delaware corporation and a direct wholly-owned subsidiary of AHPAC (“Avista Merger Sub”) and Organogenesis Inc., a Delaware corporation (“Organogenesis Inc.”). As a result of the Avista Merger and the other transactions contemplated by the Avista Merger Agreement, Avista Merger Sub merged with and into Organogenesis Inc., with Organogenesis Inc. surviving the Avista Merger and becoming a wholly-owned subsidiary of AHPAC. AHPAC changed its name to Organogenesis Holdings Inc. (ORGO). The Avista Merger was accounted for as a reverse merger in accordance with accounting principles generally accepted in the United States of America (“GAAP”). Under this method of accounting, AHPAC was treated as the “acquired” company for accounting purposes. This determination was primarily based on Organogenesis Inc.’s equity holders having a majority of the voting power of the combined company, Organogenesis Inc. comprising the ongoing operations of the combined entity, Organogenesis Inc. comprising a majority of the governing body of the combined company, and Organogenesis Inc.’s senior management comprising the senior management of the combined company. Accordingly, for accounting purposes, the Avista Merger was treated as the equivalent of Organogenesis Inc. issuing stock for the net assets of AHPAC, accompanied by a recapitalization. The net assets of AHPAC were recorded at historical cost, with no goodwill or other intangible assets recorded. Operations prior to the Avista Merger are those of Organogenesis Inc. Liquidity and Financial Conditions In accordance with ASC 205-40, Going Concern 205-40”), a s for at least 12 months beyond the filing date of this quarterly report. The Company may seek to raise additional funding through public and/or private equity financings, debt financings or other strategic transactions. There can be no assurance that the Company will be able to obtain additional debt or equity financing on terms acceptable to the Company, on a timely basis or at all. The failure of the Company to obtain sufficient funds on acceptable terms when needed could have a material adverse effect on the Company’s business, results of operations, and financial condition.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2019
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Unaudited Interim Financial Information The accompanying unaudited consolidated financial statements have been prepared by management in accordance with accounting principles generally accepted in the United States of America (“GAAP”) and in accordance with the rules and regulations of the Securities and Exchange Commission (the “SEC”) regarding interim financial reporting. Accordingly, they do not include all the information and footnotes required by generally accepted accounting principles for complete financial statements. While we believe that the disclosures presented are adequate in order to make the information not misleading, these unaudited quarterly financial statements should be read in conjunction with the financial statements and notes thereto included in the Company’s Annual Report on Form 10-K The unaudited consolidated financial statements include the accounts and results of operations of Organogenesis Holdings Inc. and its wholly-owned or controlled subsidiaries. For periods prior to the closing of the Avista Merger on December 10, 2018, the notes to the unaudited consolidated financial statements have been updated to give effect to the Avista Merger. All intercompany balances and transactions have been eliminated in consolidation. The Company considers events or transactions that occur after the balance sheet date but before the financial statements are issued to provide additional evidence relative to certain estimates or to identify matters that require additional disclosure. In the opinion of management, the unaudited consolidated financial statements reflect all adjustments of a normal recurring nature necessary for a fair presentation of the Company’s financial position, results of operations and cash flows at the dates and for the periods indicated. The results for the nine months ended September 30, 2019 are not necessarily indicative of the results to be expected for the year ending December 31, 2019, any other interim periods, or any future year or period. Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported results of operations during the reporting period. Actual results could differ from those estimates. Summary of Significant Accounting Policies The Company’s significant accounting policies are described in Note 2, “Summary of Significant Accounting Policies,” to the Consolidated Financial Statements included in the Annual Report. There have been no material changes to the significant accounting policies previously disclosed in the Annual Report other than as noted below. Adoption of ASC Topic 606, Revenue from Contracts with Customers (“ASC 606”) The Company adopted ASC 606 on January 1, 2019, using the modified retrospective method for all contracts not completed as of the date of adoption. The reported results for the fiscal year 2019 reflect the application of ASC 606 guidance while the reported results for the fiscal year 2018 were prepared under the guidance of ASC Topic 605, Revenue Recognition Historically, for certain customers, products were shipped in advance of the receipt of a purchase order and the Company recognized revenue on these products only upon receipt of the purchase order which is when the transaction price was deemed fixed and determinable. As control of these products has transferred upon use of the product in a procedure, the recognition of revenue is accelerated to the procedure date under ASC 606. The adoption of ASC 606 did not have a material impact on the Company’s consolidated financial position, results of operations, equity or cash flows as of the adoption date or for the three and nine months ended September 30, 2019. Product Revenue The Company generates revenue through the sale of Advanced Wound Care and Surgical & Sports Medicine products. There is a single performance obligation in all of the Company’s contracts, which is the Company’s promise to transfer the Company’s product to customers based on specific payment and shipping terms in the arrangement. The entire transaction price is allocated to the single performance obligation. Product revenue is recognized when a customer obtains control of the Company’s product which occurs at a point in time and may be upon shipment, procedure date, or delivery, based on the terms of the contract. Reserves for Variable Consideration Revenues from product sales are recorded net of reserves for variable consideration which includes but is not limited to product return, discounts, rebates and group purchasing organization (“GPO”) fees that are offered within contracts between the Company and its customers relating to the Company’s sales of its products. These reserves are based on the amounts earned or to be claimed by its customers on the related sales and are recorded as reductions of accounts receivable or an establishment of a liability. Where appropriate, these estimates take into consideration a range of possible outcomes which are probability-weighted for relevant factors such as the Company’s historical experience, current contractual and statutory requirements, specific known market events and trends, industry data and forecasted customer buying and payment patterns. Overall, these reserves reflect the Company’s best estimates of the amount of consideration to which it is entitled based on the terms of the contract and is included in the net sales price to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. Actual amounts of consideration ultimately paid may differ from the Company’s estimates. If actual results in the future vary from the Company’s estimates, the Company adjusts these estimates, which would affect net product revenue and earnings in the period such variances become known. Product Returns Consistent with industry practice, the Company generally offers customers a limited right of return for product purchased. The Company estimates the amount of its product sales that may be returned by its customers and records this estimate as a reduction of revenue in the period the related product revenue is recognized. The Company currently estimates product return reserves using its actual and historical return rates as well as factors that it becomes aware of that it believes could significantly impact its expected returns, including product recalls, pricing changes, or change in reimbursement rates. The Company does not record an asset for the returned product as the product is discarded upon receipt. Rebates and Allowances The Company provides certain customers with rebates and allowances that are explicitly stated in the Company’s contracts, resulting in a reduction o f GPO Fees The Company pays fees to GPOs for administrative services that the GPOs perform in connection with the purchases of product by the GPO members. These fees are based on a contractually-determined percentage of the Company’s applicable sales. The Company classifies these GPO fees as a reduction of revenue or as an operating expense based on the substance of the relationship of all parties involved in the transaction. For the three months ended September 30, 2019 and 2018, the Company recorded GPO fees of $880 and $581, respectively, as a direct reduction of revenue. For the nine months ended September 30, 2019 and 2018, the Company recorded GPO fees of $1,991 and $1,304 r Other Revenue Policies Sales, value add, and other taxes collected on behalf of third parties are excluded from revenue. Applying the practical expedient in paragraph ASC 606-10-32-18, Applying the practical expedient in ASC 340-40-25-4, applying the practical expedient in ASC 606-10-25-18B Disaggregation of Revenue The following table sets forth revenue by product category: Three Months Ended September 30, 2019 2018 Advanced Wound Care $ 54,310 $ 43,597 Surgical & Sports Medicine 9,955 7,172 Total net $ 64,265 $ 50,769 Nine Months Ended September 30, 2019 2018 Advanced Wound Care $ 157,365 $ 109,711 Surgical & Sports Medicine 28,971 20,139 Total net $ 186,336 $ 129,850 For the three and nine months ended September 30, 2019, net PuraPly revenue totaled $31,755 and $86,893, respectively. For the three and nine months ended September 30, 2018, net PuraPly revenue totaled $17,872 and $41,261, respectively. For all periods presented, n et net Reclassification of Prior Period Balances Reclassifications have been made to prior period amounts to conform to the current-year presentation of the reporting of deferred interest and principal on outstanding capital lease obligations and deferred tenant escalations as long-term liabilities on the consolidated balance sheets. The deferred interest and tenant escalation amounts were previously reported as accrued expenses on the consolidated balance sheets and the deferred principal on the capital lease obligations were recorded as part of the current portion of capital lease obligations on the consolidated balance sheet. These reclassifications have no effect on the reported net loss or equity for the periods ended September 30, 2018 or December 31, 2018. Reclassification has been made to prior period amounts reported in the cash flows from operating activities section of the cash flow statement to conform to the current year presentation. The provision recorded for inventory reserve has been reduced by amounts not related to excess and obsolete inventory and change in inventory has been increased by a corresponding amount. The reclassification has no effect on the reported balance sheet, net loss or equity for the periods ended September 30, 2018 or December 31, 2018. Recently Issued Accounting Pronouncements Not Yet Adopted In February 2016, the Financial Accounting Standards Board (“FASB”) issued ASU 2016-02, Leases (Topic 842) 2016-02”), 2018-10, Codification Improvements to Topic 842, Leases 2016-02, 2018-11, Leases (Topic 842): Targeted Improvements 2016-02, 2019-01, Leases (Topic 842): Codification Improvements 2016-02 right-of-use Recently Adopted Accounting Pronouncements In September 2018, the FASB issued ASU 2018-07, Compensation-Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting Topic 718, Compensation—Stock Compensation

Fair Value of Financial Assets

Fair Value of Financial Assets and Liabilities	9 Months Ended
	Sep. 30, 2019
Fair Value Disclosures [Abstract]
Fair Value of Financial Assets and Liabilities	3. Fair Value of Financial Assets and Liabilities The following table presents information about the Company’s financial assets and liabilities measured at fair value on a recurring basis and indicates the level of the fair value hierarchy utilized to determine such fair values as of December 31, 2018. The redeemable common stock liability was settled in March 2019 as described below. Fair Value Measurements as of December 31, 2018 Using: Level 1 Level 2 Level 3 Total Liabilities: Redeemable common stock liability $ — $ — $ 6,762 $ 6,762 $ — $ — $ 6,762 $ 6,762 Redeemable Common Stock On March 24, 2017, the Company issued 728,548 shares of Class A common stock in connection with the NuTech Medical acquisition

Accounts receivable, net

Accounts receivable, net	9 Months Ended
	Sep. 30, 2019
Receivables [Abstract]
Accounts receivable, net	4. Accounts Receivable, Net Accounts receivable consisted of the following: September 30, December 31, 2019 2018 Accounts receivable $ 37,318 $ 37,497 Less — allowance for sales returns and doubtful accounts (2,935 ) (3,420 ) $ 34,383 $ 34,077 The Company’s allowance for sales returns and doubtful accounts was comprised of the following: Three Months Ended September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Balance at beginning of period $ 3,021 $ 2,853 $ 3,420 $ 3,225 Additions (reductions) (56 ) 289 (29 ) (18 ) Write-offs (30 ) (51 ) (456 ) (116 ) Balance at end of period $ 2,935 $ 3,091 $ 2,935 $ 3,091

Inventories

Inventories	9 Months Ended
	Sep. 30, 2019
Inventory Disclosure [Abstract]
Inventories	5. Inventories Inventories, net of related reserves for excess and obsolescence, consisted of the following: September 30, December 31, 2019 2018 Raw materials $ 7,430 $ 4,711 Work in process 1,355 1,759 Finished goods 11,399 6,851 $ 20,184 $ 13,321 Raw materials include various components used in the Company’s manufacturing process. The Company’s excess and obsolete inventory review process includes analysis of sales forecasts and historical sales as compared to inventory level, and working with operations to maximize recovery of excess inventory. During the three months ended September 30, 2019 and 2018, the Company charged $286 and $370, respectively, for inventory excess and obsolescence to cost of goods sold within the consolidated statements of operations. During the nine months ended September 30, 2019 and 2018, the Company charged $809 and $2,068, respectively, for inventory excess and obsolescence to cost of goods sold within the consolidated statements of operations. As of September 30, 2019 and December 31, 2018, the Company recorded a reserve for excess and obsolete inventory of $1,262 and $1,206, respectively.

Property and Equipment, Net

Property and Equipment, Net	9 Months Ended
	Sep. 30, 2019
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	6. Property and Equipment, Net Property and equipment consisted of the following: September 30, December 31, 2019 2018 Leasehold improvements $ 35,092 $ 34,345 Furniture, computers and equipment 46,038 44,752 81,130 79,097 Accumulated depreciation and amortization (64,977 ) (62,435 ) Construction in progress 28,101 22,961 $ 44,254 $ 39,623 Depreciation expense was $792 and $861 for the three months ended September 30, 2019 and 2018, respectively. Depreciation expense was $2,553 and $2,608 for the nine months ended September 30, 2019 and 2018, respectively. As of September 30, 2019 and December 31, 2018, the Company had $21,689 of buildings under capital leases recorded within leasehold improvements. As of September 30, 2019 and December 31, 2018, the Company had $13,477 and $12,579 recorded within accumulated depreciation and amortization related to buildings under capital leases, respectively. Construction in progress primarily represents unfinished construction work on the 275 Dan Road SPE, LLC property and, more recently, improvements at the Company’s leased facilit ies

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	7. Goodwill and Intangible Assets Goodwill was $25,539 as of September 30, 2019 and December 31, 2018. There were no impairments recorded against goodwill during the three and nine months ended September 30, 2019 and year ended December 31, 2018. In April, 2019, the Company purchased $750 of intangibles related to patent and know-how the ing Original Accumulated Net Book Cost Amortization Value Developed technology $ 30,570 $ (10,556 ) $ 20,014 Trade names and trademarks 2,000 (592 ) 1,408 Independent sales agency network 4,500 (3,767 ) 733 Non-compete 260 (101 ) 159 Total $ 37,330 $ (15,016 ) $ 22,314 Identifiable intangible assets consisted of the following as of December 31, 2018: Original Accumulated Net Book Cost Amortization Value Developed technology $ 29,820 $ (8,454 ) $ 21,366 Trade names and trademarks 2,000 (413 ) 1,587 Independent sales agency network 4,500 (1,569 ) 2,931 Non-compete 260 (53 ) 207 Total $ 36,580 $ (10,489 ) $ 26,091 Amortization of intangible assets, calculated on a straight - or ver ere ,

Accrued Expenses

Accrued Expenses	9 Months Ended
	Sep. 30, 2019
Payables and Accruals [Abstract]
Accrued Expenses	8. Accrued Expenses Accrued expenses and other current liabilities consisted of the following: September 30, December 31, 2019 2018 Accrued personnel costs $ 15,100 $ 15,218 Other 5,506 5,170 $ 20,606 $ 20,388

Line of Credit and Notes Payabl

Line of Credit and Notes Payable	9 Months Ended
	Sep. 30, 2019
Line of Credit Facility [Abstract]
Line of Credit and Notes Payable	9. Line of Credit and Notes Payable Line of credit and notes payable consisted of the following: September 30, December 31, 2019 2018 Line of credit $ 33,484 $ 26,484 Term loan 50,000 — Less debt discount and debt issuance cost (401 ) — less current maturities — — Term loan, net of debt discount and debt issuance cost $ 49,599 $ — Notes payable — 15,885 Less debt discount and debt issuance cost — (762 ) less current maturities — (2,545 ) Notes payable, net of debt discount and debt issuance cost $ — $ 12,578 New Credit Agreemen t In March 2019, the Company and its subsidiaries, Organogenesis Inc. and Prime Merger Sub, LLC (collectively, and jointly and severally, “Borrower”), and Silicon Valley Bank (“SVB”), as Administrative Agent, Issuing Lender and Swingline Lender, and the several other lenders thereto (the “Lenders”) entered into a Credit Agreement (the “New Credit Agreement”) providing for a term loan (the “Term Loan Facility”) and a revolving credit facility (the “Revolving Facility”, and together with the Term Loan Facility, the “Debt Facility”) in an aggregate principal amount of $100,000. The Term Loan Facility is structured in three tranches, as follows: (i) the first tranche of $40,000 was made available to Borrower and fully funded on March 14, 2019; (ii) the second tranche of $10,000 was made available to Borrower in September 2019 upon: (a) Borrower’s demonstrated compliance with the financial covenants in the New Credit Agreement and (b) Borrower’s achievement of trailing twelve month Consolidated Revenue of not less than $221,250 and a trailing three month Adjusted EBITDA (as defined in the New Credit Agreement) loss not in excess of $5,000; and (iii) the third tranche of $10,000 w ould March 31, 2020 subject to thirty-six Borrower’s final payment on the Term Loan Facility, due on the Term Loan Maturity Date, will include all outstanding principal and accrued and unpaid interest under the Term Loan Facility, plus a final payment (the “Final Payment”) equal to the original aggregate principal amount of the Term Loan Facility multiplied by 6.25%. Borrower may prepay the Term Loan Facility, subject to paying the Prepayment Premium (described below) and the Final Payment. The Prepayment Premium is equal to 3.00% of the outstanding principal amount of the Term Loan Facility if the prepayment occurs on or prior to the one year anniversary of the closing, 2.00% of the outstanding principal amount of the Term Loan Facility if the prepayment occurs after such one year anniversary and prior to the second anniversary of the closing, and 1.00% of the outstanding principal amount of the Term Loan Facility if the prepayment occurs after the two year anniversary but prior to the three year anniversary of the closing, and 0% thereafter. Once repaid, amounts borrowed under the Term Loan Facility may not be re-borrowed. The Revolving Facility is equal to the lesser of $40,000 and the amount determined by the Borrowing Base, which is defined as a percentage of the Company’s book value of qualifying finished goods inventory and eligible accounts receivable. The interest rate for advances under the Revolving Facility is a floating per annum interest rate equal to the Wall Street Journal Prime Rate. In the event that the aggregate amount of interest earned by the Lenders from the Revolving Facility in any given month is less than the interest that would have been earned if Borrower had average outstanding advances in an amount equal to 25% of the then-available Revolving Commitments (as defined in the New Credit Agreement) then Borrower must pay the Administrative the minus Borrower may elect to reduce or terminate the Revolving Facility in its entirety at any time by repaying all outstanding principal, unpaid accrued interest and a reduction or termination fee equal to 4.00% of the aggregate Revolving Commitments so reduced or terminated if the reduction or termination occurs on or prior to the one year anniversary of the closing, 3.00% of the aggregate Revolving Commitments so reduced or terminated if the reduction or termination occurs after such one year anniversary and prior to the second anniversary of the closing, and 2.00% of the aggregate Revolving Commitments so reduced or terminated if the reduction or termination occurs after the two year anniversary but prior to the three year anniversary of the closing, and $0 thereafter. Under the New Credit Agreement, Borrower is required to achieve Minimum Trailing Twelve Month Consolidated Revenue (as defined in the New Credit Agreement), tested quarterly, at the following levels: $200,000 for the trailing twelve months ending March 31, 2019; $213,500 for the trailing twelve months ending June 30, 2019; $221,250 for the trailing twelve months ending September 30, 2019 As of September 30, 2019, the Company was in compliance with the financial covenants under the New Credit Agreement and had borrowings Future payments of Term Loan Facility, as of September 30, 2019, are as follows for the calendar years ended December 31: 2019 $ — 2020 — 2021 13,888 2022 16,667 2023 16,667 2024 2,778 Total $ 50,000 Credit Agreement On March 21, 2017, the Company entered into a credit agreement (the “Credit Agreement”) with SVB whereby SVB agreed to extend to the Company a revolving credit facility in an aggregate amount not to exceed $30,000 with a letter of credit sub-facility sub-facility sub-facilities On March 14, 2019, $26,541, representing all outstanding unpaid principal and accrued interest relating to the revolving borrowing due under the Credit Agreement, was rolled into the New Credit Agreement. Master Lease Agreement On April 28, 2017, the Company entered into the Master Lease Agreement (the “ML Agreement”) with Eastward Fund Management LLC that allowed the Company to borrow up to $20,000 on or prior to June

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2019
Equity [Abstract]
Stockholders' Equity	10. Stockholders’ Equity Common Stock As of September 30, 2019, the authorized capital stock of the Company included 400,000,000 shares of Class A common stock, $0.0001 par value. 95,470,290 shares of Class A common stock were issued as of September 30, 2019 which includes 728,548 shares that were reacquired in connection with the redemption of redeemable shares in March 2019. See Note 3. At September 30, 2019 and December 31, 2018, the Company has reserved the following shares of Class A common stock for future issuance: September 30, December 31, 2019 2018 Shares reserved for issuance for outstanding options 6,588,000 6,590,195 Shares reserved for issuance for future option grant 9,008,996 9,108,996 Shares reserved for issuance under the warrants — 17,732,700 Total shares of authorized common stock reserved for future issuance 15,596,996 33,431,891 Warrant Exchange and Warrant Exercise On July 22, 2019, the Company made an exchange offer (the “Exchange Offer”) to all holders of the Company’s 30.9 million outstanding warrants, that were issued in connection with the Company’s initial public offering pursuant to a prospectus dated October 10, 2016 (the “Public Warrants”), to exchange 0.095 shares of Class A common stock for each Public Warrant tendered. On August 16, 2019, the expiration date of the Exchange Offer, a total of 29,950,150 warrants were tendered, resulting in the issuance of 2,845,280 shares of common stock. On August 19, 2019, the Company executed an amendment to the warrant agreement, dated October 10, 2016, governing its outstanding Public Warrants to provide the Company with the right to require the Public Warrants holders to exchange one share of their Public Warrant for 0.0855 shares of the Company’s Class A common stock. Pursuant to the amendment, the Company issued 80,451 additional shares in exchange for all remaining untendered Public Warrants. Pursuant to the terms of the Company’s previously announced Warrant Exchange Agreement dated July 12, 2019, with Avista Capital Partners IV L.P., and Avista Capital Partners IV (Offshore), L.P. (collectively, the “PIPE Investors”), the Company issued an aggregate of 389,501 shares of Class A common stock, to the PIPE Investors, at the same exchange ratio offered to the Public Warrant holders in the Exchange Offer, in exchange for an aggregate of 4,100,000 private placement warrants. On August 13, 2019, Massachusetts Capital Resource Company and Life Insurance Community Investment Initiative, LLC (the “Lender Warrant Holders”) net exercised outstanding warrants to purchase an aggregate of 182,700 shares of the Company’s Class A common stock at an exercise price of $3.95 per share. The Company issued an aggregate of 19,426 shares of common stock in connection with this transaction. As a result of these transactions, the Company issued an aggregate of 3,334,658 shares of common stock, representing approximately 3% of the total Class A common stock outstanding after such issuances. As of September 30, 2019, no warrants were outstanding. As the fair value of the warrants exchanged in the warrant exchange transactions immediately prior to the exchanges was less than the fair value of the common stock issued, the Company recorded a non-cash deemed dividend for the incremental fair value provided to the warrant holders in the three months ended September 30, 2019.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2019
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock-Based Compensation	11. Stock-Based Compensation Stock Incentive Plans 2018 Stock Incentive Plan On November 28, 2018, the board of directors of the Company adopted, and on December 10, 2018 the Company’s stockholders approved, the Organogenesis 2018 Equity and Incentive Plan (the “2018 Plan”). The purposes of the 2018 Plan are to provide long-term incentives and rewards to the Company’s employees, officers, directors and other key persons (including consultants), to attract and retain persons with the requisite experience and ability, and to more closely align the interests of such employees, officers, directors and other key persons with the interests of the Company’s stockholders. The 2018 Plan authorizes the Company’s board of directors or a committee of not less than two independent directors (in either case, the “Administrator”) to grant the following types of awards: non-statutory As of September 30, 2019, a total of 9,198,996 shares of Class A common stock have been authorized to be issued under the 2018 Plan (subject to adjustment in the case of any stock dividend, stock split, reverse stock split, or similar change in capitalization of the Company). As of September 30, 2019, options to purchase 190,000 shares of Class A common stock were outstanding under the 2018 Plan. No other awards have been issued under the 2018 Plan. 2003 Stock Incentive Plan The Organogenesis 2003 Stock Incentive Plan (the “2003 Plan”), provides for the Company to issue restricted stock awards, or to grant incentive stock options or non-statutory non-statutory As of the closing of the Avista Merger on December 10, 2018, a total of 7,176,715 shares of Class A common stock were issuable upon exercise of outstanding options under the 2003 Plan. Effective as of the closing of the Avista Merger on December 10, 2018, no additional awards may be made under the 2003 Plan and as a result (i) any shares in respect of stock options that are expired or terminated under the 2003 Plan without having been fully exercised will not be available for future awards; (ii) any shares in respect of restricted stock that are forfeited to, or otherwise repurchased by the Company, will not be available for future awards; and (iii) any shares of common stock that are tendered to the Company by a participant to exercise an award will not be available for future awards. Following the closing of the Avista Merger, the 2003 Plan is administered by the Company’s board of directors. Stock-Based Compensation Expenses Stock options awarded under the 2018 Plan and the 2003 Plan expire 10 years after the grant date and typically vest over four or five years. Stock-based compensation expense was $242 and $252 for the three months ended September 30, 2019 and 2018, respectively, and was $700 and $820 for the nine months ended September 30, 2019 and 2018, respectively. The total amount of stock-based compensation expenses was included within selling, general and administrative on the consolidated statements of operations. Stock Option Valuation The stock options granted during the nine months ended September 30, 2019 and September 30, 2018 were 100,000 and 78,111, respectively. The assumptions that the Company used to determine the grant-date fair value of stock options granted during these periods were as follows, presented on a weighted-average basis: September 30, September 30, Risk-free interest rate 2.24 % 2.74 % Expected term (in years) 6.50 5.82 Expected volatility 42.7 % 42.9 % Expected dividend yield 0.0 % 0.0 % Exercise price $ 7.08 $ 5.40 Underlying stock price $ 7.08 $ 5.40 These assumptions resulted in an estimated weighted - Stock Option Activity The following table summarizes the Company’s stock option activity since December 31, 2018 (in thousands, except share and per share amounts): Number of Weighted Weighted Aggregate Outstanding as of December 31, 2018 7,266,185 $ 1.92 5.89 $ 33,909 Granted 100,000 7.08 Canceled / forfeited (11,150 ) 2.87 Exercised (91,045 ) 1.77 382 Outstanding as of September 30, 2019 7,263,990 1.99 5.31 33,359 Options exercisable as of September 30, 2019 5,736,926 1.59 4.69 28,546 Options vested or expected to vest as of September 30, 2019 7,025,841 $ 1.91 5.20 $ 32,797 The aggregate intrinsic value of stock options is calculated as the difference between the exercise price of the stock options and the fair value of the Company’s Class A common stock for those stock options that had exercise prices lower than the fair value of the Company’s Class A common stock. The total fair value of options vested during the nine months ended September 30, 2019 and 2018 was $538 and $503, respectively. As of September 30, 2019, the total unrecognized stock compensation expense was $1,444 and is expected to be recognized over a weighted-average period of 2.59 years. A s of paid-in o in prior periods

Net Loss Per Share

Net Loss Per Share	9 Months Ended
	Sep. 30, 2019
Earnings Per Share [Abstract]
Net Loss Per Share	12. Net Loss per Share The Company’s potentially dilutive securities, which include redeemable common stock and and warrants , - The Company excluded the following potential shares of Class A common stock, presented based on amounts outstanding at each period end, from the computation of diluted net loss per share attributable to the common stockholders of Organogenesis Holdings Inc. for the periods indicated because including them would have had an anti-dilutive effect: Nine Months Ended September 30, 2019 2018 Options to purchase common stock 7,263,990 7,178,774 Redeemable common stock — 728,548 Warrants to purchase common stock — 1,561,485 7,263,990 9,468,807

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2019
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies Disclosure	13. Commitments and Contingencies Capitalized Leases On January 1, 2013, the Company entered into capital lease arrangements with 65 Dan Road SPE, LLC, 85 Dan Road Associates, LLC, Dan Road Equity I, LLC and 275 Dan Road SPE, LLC for office and laboratory space in Canton, Massachusetts. 65 Dan Road SPE, LLC, 85 Dan Road Associates, LLC, Dan Road Equity I, LLC and 275 Dan Road SPE, LLC are related parties as the owners of these entities are also stockholders of the Company. The leases terminate on December 31, 2022 and each contains a renewal option for a five-year period with the The Company records the capital lease asset within property and equipment and the liability is recorded within the capital lease obligations on the consolidated balance sheets. As of September 30, 2019 and December 31, 2018, the Company owed an aggregate of $10,336 and $10,293, respectively, of accrued but unpaid lease obligations. These accrued but unpaid lease obligations are subordinated to the New Credit Agreement and will not be paid until the debt under the New Credit Agreement is paid off. The principal portion of rent in arrears on the capital leases totaled $6,042 and $5,265 as of September 30, 2019 and December 31, 2018, respectively, and is included in the long-term portion of capital lease obligations. The interest portion of rent in arrears totaled $3,650 and $4,174 as of September 30, 2019 and December 31, 2018, respectively, and is included in other liabilities on the consolidated balance sheets. In addition to rent, the Company is responsible for payment of all operating costs and common area maintenance under the aforementioned leases. As of September 30, 2019 and December 31, 2018, the Company owed $644 and $854, respectively, of operating and common area maintenance costs which are included in other liabilities on the consolidated balance sheets. Effective April 1, 2019, the Company agreed to accrue interest on the accrued but unpaid lease obligations at an interest rate equal to the rate charged in the New Credit Agreement (see Note 9). The accrued interest is also subordinated to the New Credit Agreement and, as such, is included in other liabilities on the consolidated balance sheet. Interest accrued as of September 30, 2019 totaled $478. Future obligations under capital leases in the aggregate and for the next five years is as follows: 2019 (remaining three months) $ 1,180 2020 4,721 2021 4,721 2022 4,945 2023 — Thereafter 9,692 25,259 Less amount representing interest (7,494 ) Present value of minimum lease payments 17,765 Less current maturities (2,872 ) Long-term portion $ 14,893 Operating Leases The Company leases vehicles for certain employees and have fleet services agreements for service on these vehicles. The minimum lease term for each newly leased vehicle is one year with three consecutive one-year In i I ten-year Operating lease expense s ere 1,218 , 3,630 Future minimum lease payments due under noncancelable operating lease agreements as of September 30, 2019 are as follows: 2019 (remaining three months) $ 1,218 2020 5,714 2021 5,053 2022 2,558 2023 1,180 Thereafter 8,123 $ 23,846 Royalty Commitments The Company entered into a license agreement with a university for certain patent rights related to the development, use, and production of one of its advanced wound care products. Under this agreement, the Company incurred a royalty based on a percentage of net product sales, for the use of these patents until the patents expired, which was in November 2006. Accrued royalties totaled $1,187 as of September 30, 2019 and December 31, 2018, and are classified as part of accrued expenses on the Company’s consolidated balance sheets. There was no royalty expense incurred during the three and nine months ended September 30, 2019 and 2018 related to this agreement. In October 2017, the Company entered into a license agreement to resolve a patent infringement claim by a third party. Under the license agreement, the Company is required to pay royalties based on a percentage of net sales of the licensed product that occur, after December 31, 2016, through the expiration date of the underlying patent, subject to minimum royalty payment provisions. The Company recorded royalty expense of $991 and $506 during the three months ended September 30, 2019 and 2018, respectively, within selling, general and administrative expenses on the consolidated statement of operations. The Company recorded royalty expense of $2,695 and $1,207 during the nine months ended September 30, 2019 and 2018, respectively, within selling, general and administrative expenses on the consolidated statement of operations. Legal Proceedings In conducting its activities, the Company, from time to time, is subject to various claims and also has claims against others. In management’s opinion, the ultimate resolution of such claims would not have a material effect on the financial position of the Company. The Company accrues for these claims when amounts due are probable and estimable. The Company accrued $ 542 , respectively, The purchase price for NuTech Medical included $7,500 of future payments issued as deferred acquisition consideration. As of September 30, 2019, the Company has paid $2,500 in deferred acquisition consideration. The amount, if any, of the remaining $5,000 of deferred acquisition consideration plus accrued interest owed to the sellers of NuTech Medical is currently in dispute. As of September 30, 2019, the Company recorded $842 of accrued interest related to the deferred acquisition consideration which is recorded in accrued expenses and other current liabilities. The Company has asserted certain claims for indemnification that would offset in whole or in part its payment obligation and the sellers of NuTech Medical have filed a lawsuit alleging breach of contract and seeking specific performance of the alleged payment obligation and attorneys’ fees.

Related Party Transactions

Related Party Transactions	9 Months Ended
	Sep. 30, 2019
Related Party Transactions [Abstract]
Related Party Transactions	14. Related Party Transactions Capital lease obligations to affiliates are further described in Note 13. During 2010, the Company’s board of directors approved a loan program that permitted the Company to make loans to three executives of the Company (the “Employer Loans”) to (i) provide them with liquidity (“Liquidity Loans”) and (ii) fund the exercise of vested stock options (“Option Loans”). The Employer Loans mature with all principal and accrued interest due on the tenth anniversary of the issuance date of each subject loan, except that in certain circumstances , In connection with the acquisition of NuTech Medical, the Company entered into an operating lease with Oxmoor Holdings, LLC, an entity that is affiliated with the former sole shareholder of NuTech Medical, related to the facility at NuTech Medical’s headquarters in Birmingham, Alabama. Under the lease, the Company is required to make monthly rent payments of approximately $21 through December 31, 2020.

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2019
Subsequent Events [Abstract]
Subsequent Events	15. Subsequent Events The Company has evaluated subsequent events through November 12, 2019, the date on which these consolidated financial statements were issued and has determined that there are no such events to report.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2019
Accounting Policies [Abstract]
Unaudited Interim Financial Information	Unaudited Interim Financial Information The accompanying unaudited consolidated financial statements have been prepared by management in accordance with accounting principles generally accepted in the United States of America (“GAAP”) and in accordance with the rules and regulations of the Securities and Exchange Commission (the “SEC”) regarding interim financial reporting. Accordingly, they do not include all the information and footnotes required by generally accepted accounting principles for complete financial statements. While we believe that the disclosures presented are adequate in order to make the information not misleading, these unaudited quarterly financial statements should be read in conjunction with the financial statements and notes thereto included in the Company’s Annual Report on Form 10-K The unaudited consolidated financial statements include the accounts and results of operations of Organogenesis Holdings Inc. and its wholly-owned or controlled subsidiaries. For periods prior to the closing of the Avista Merger on December 10, 2018, the notes to the unaudited consolidated financial statements have been updated to give effect to the Avista Merger. All intercompany balances and transactions have been eliminated in consolidation. The Company considers events or transactions that occur after the balance sheet date but before the financial statements are issued to provide additional evidence relative to certain estimates or to identify matters that require additional disclosure. In the opinion of management, the unaudited consolidated financial statements reflect all adjustments of a normal recurring nature necessary for a fair presentation of the Company’s financial position, results of operations and cash flows at the dates and for the periods indicated. The results for the nine months ended September 30, 2019 are not necessarily indicative of the results to be expected for the year ending December 31, 2019, any other interim periods, or any future year or period.
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported results of operations during the reporting period. Actual results could differ from those estimates.
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies The Company’s significant accounting policies are described in Note 2, “Summary of Significant Accounting Policies,” to the Consolidated Financial Statements included in the Annual Report. There have been no material changes to the significant accounting policies previously disclosed in the Annual Report other than as noted below.
Revenue from Contract with Customer	Adoption of ASC Topic 606, Revenue from Contracts with Customers (“ASC 606”) The Company adopted ASC 606 on January 1, 2019, using the modified retrospective method for all contracts not completed as of the date of adoption. The reported results for the fiscal year 2019 reflect the application of ASC 606 guidance while the reported results for the fiscal year 2018 were prepared under the guidance of ASC Topic 605, Revenue Recognition Historically, for certain customers, products were shipped in advance of the receipt of a purchase order and the Company recognized revenue on these products only upon receipt of the purchase order which is when the transaction price was deemed fixed and determinable. As control of these products has transferred upon use of the product in a procedure, the recognition of revenue is accelerated to the procedure date under ASC 606. The adoption of ASC 606 did not have a material impact on the Company’s consolidated financial position, results of operations, equity or cash flows as of the adoption date or for the three and nine months ended September 30, 2019. Product Revenue The Company generates revenue through the sale of Advanced Wound Care and Surgical & Sports Medicine products. There is a single performance obligation in all of the Company’s contracts, which is the Company’s promise to transfer the Company’s product to customers based on specific payment and shipping terms in the arrangement. The entire transaction price is allocated to the single performance obligation. Product revenue is recognized when a customer obtains control of the Company’s product which occurs at a point in time and may be upon shipment, procedure date, or delivery, based on the terms of the contract. Reserves for Variable Consideration Revenues from product sales are recorded net of reserves for variable consideration which includes but is not limited to product return, discounts, rebates and group purchasing organization (“GPO”) fees that are offered within contracts between the Company and its customers relating to the Company’s sales of its products. These reserves are based on the amounts earned or to be claimed by its customers on the related sales and are recorded as reductions of accounts receivable or an establishment of a liability. Where appropriate, these estimates take into consideration a range of possible outcomes which are probability-weighted for relevant factors such as the Company’s historical experience, current contractual and statutory requirements, specific known market events and trends, industry data and forecasted customer buying and payment patterns. Overall, these reserves reflect the Company’s best estimates of the amount of consideration to which it is entitled based on the terms of the contract and is included in the net sales price to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. Actual amounts of consideration ultimately paid may differ from the Company’s estimates. If actual results in the future vary from the Company’s estimates, the Company adjusts these estimates, which would affect net product revenue and earnings in the period such variances become known. Product Returns Consistent with industry practice, the Company generally offers customers a limited right of return for product purchased. The Company estimates the amount of its product sales that may be returned by its customers and records this estimate as a reduction of revenue in the period the related product revenue is recognized. The Company currently estimates product return reserves using its actual and historical return rates as well as factors that it becomes aware of that it believes could significantly impact its expected returns, including product recalls, pricing changes, or change in reimbursement rates. The Company does not record an asset for the returned product as the product is discarded upon receipt. Rebates and Allowances The Company provides certain customers with rebates and allowances that are explicitly stated in the Company’s contracts, resulting in a reduction o f GPO Fees The Company pays fees to GPOs for administrative services that the GPOs perform in connection with the purchases of product by the GPO members. These fees are based on a contractually-determined percentage of the Company’s applicable sales. The Company classifies these GPO fees as a reduction of revenue or as an operating expense based on the substance of the relationship of all parties involved in the transaction. For the three months ended September 30, 2019 and 2018, the Company recorded GPO fees of $880 and $581, respectively, as a direct reduction of revenue. For the nine months ended September 30, 2019 and 2018, the Company recorded GPO fees of $1,991 and $1,304 r Other Revenue Policies Sales, value add, and other taxes collected on behalf of third parties are excluded from revenue. Applying the practical expedient in paragraph ASC 606-10-32-18, Applying the practical expedient in ASC 340-40-25-4, applying the practical expedient in ASC 606-10-25-18B Disaggregation of Revenue The following table sets forth revenue by product category: Three Months Ended September 30, 2019 2018 Advanced Wound Care $ 54,310 $ 43,597 Surgical & Sports Medicine 9,955 7,172 Total net $ 64,265 $ 50,769 Nine Months Ended September 30, 2019 2018 Advanced Wound Care $ 157,365 $ 109,711 Surgical & Sports Medicine 28,971 20,139 Total net $ 186,336 $ 129,850 For the three and nine months ended September 30, 2019, net PuraPly revenue totaled $31,755 and $86,893, respectively. For the three and nine months ended September 30, 2018, net PuraPly revenue totaled $17,872 and $41,261, respectively. For all periods presented, n et net
Reclassification of Prior Period Balances	Reclassification of Prior Period Balances Reclassifications have been made to prior period amounts to conform to the current-year presentation of the reporting of deferred interest and principal on outstanding capital lease obligations and deferred tenant escalations as long-term liabilities on the consolidated balance sheets. The deferred interest and tenant escalation amounts were previously reported as accrued expenses on the consolidated balance sheets and the deferred principal on the capital lease obligations were recorded as part of the current portion of capital lease obligations on the consolidated balance sheet. These reclassifications have no effect on the reported net loss or equity for the periods ended September 30, 2018 or December 31, 2018. Reclassification has been made to prior period amounts reported in the cash flows from operating activities section of the cash flow statement to conform to the current year presentation. The provision recorded for inventory reserve has been reduced by amounts not related to excess and obsolete inventory and change in inventory has been increased by a corresponding amount. The reclassification has no effect on the reported balance sheet, net loss or equity for the periods ended September 30, 2018 or December 31, 2018.
Recently Issued Accounting Pronouncements	Recently Issued Accounting Pronouncements Not Yet Adopted In February 2016, the Financial Accounting Standards Board (“FASB”) issued ASU 2016-02, Leases (Topic 842) 2016-02”), 2018-10, Codification Improvements to Topic 842, Leases 2016-02, 2018-11, Leases (Topic 842): Targeted Improvements 2016-02, 2019-01, Leases (Topic 842): Codification Improvements 2016-02 right-of-use
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements In September 2018, the FASB issued ASU 2018-07, Compensation-Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting Topic 718, Compensation—Stock Compensation

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2019
Accounting Policies [Abstract]
Schedule of Revenue by Product Category	The following table sets forth revenue by product category: Three Months Ended September 30, 2019 2018 Advanced Wound Care $ 54,310 $ 43,597 Surgical & Sports Medicine 9,955 7,172 Total net $ 64,265 $ 50,769 Nine Months Ended September 30, 2019 2018 Advanced Wound Care $ 157,365 $ 109,711 Surgical & Sports Medicine 28,971 20,139 Total net $ 186,336 $ 129,850

Fair Value of Financial Asset_2

Fair Value of Financial Assets and Liabilities (Tables)	9 Months Ended
	Sep. 30, 2019
Fair Value Disclosures [Abstract]
Fair Value, by Balance Sheet Grouping	The following table presents information about the Company’s financial assets and liabilities measured at fair value on a recurring basis and indicates the level of the fair value hierarchy utilized to determine such fair values as of December 31, 2018. The redeemable common stock liability was settled in March 2019 as described below. Fair Value Measurements as of December 31, 2018 Using: Level 1 Level 2 Level 3 Total Liabilities: Redeemable common stock liability $ — $ — $ 6,762 $ 6,762 $ — $ — $ 6,762 $ 6,762

Accounts receivable, net (Table

Accounts receivable, net (Tables)	9 Months Ended
	Sep. 30, 2019
Receivables [Abstract]
Schedule of accounts receivable	Accounts receivable consisted of the following: September 30, December 31, 2019 2018 Accounts receivable $ 37,318 $ 37,497 Less — allowance for sales returns and doubtful accounts (2,935 ) (3,420 ) $ 34,383 $ 34,077
Schedule of allowance for sales returns and doubtful accounts	The Company’s allowance for sales returns and doubtful accounts was comprised of the following: Three Months Ended September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Balance at beginning of period $ 3,021 $ 2,853 $ 3,420 $ 3,225 Additions (reductions) (56 ) 289 (29 ) (18 ) Write-offs (30 ) (51 ) (456 ) (116 ) Balance at end of period $ 2,935 $ 3,091 $ 2,935 $ 3,091

Inventories (Tables)

Inventories (Tables)	9 Months Ended
	Sep. 30, 2019
Inventory Disclosure [Abstract]
Schedule of Inventory, Current	Inventories, net of related reserves for excess and obsolescence, consisted of the following: September 30, December 31, 2019 2018 Raw materials $ 7,430 $ 4,711 Work in process 1,355 1,759 Finished goods 11,399 6,851 $ 20,184 $ 13,321

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)	9 Months Ended
	Sep. 30, 2019
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	Property and equipment consisted of the following: September 30, December 31, 2019 2018 Leasehold improvements $ 35,092 $ 34,345 Furniture, computers and equipment 46,038 44,752 81,130 79,097 Accumulated depreciation and amortization (64,977 ) (62,435 ) Construction in progress 28,101 22,961 $ 44,254 $ 39,623

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Finite-Lived Intangible Assets	Original Accumulated Net Book Cost Amortization Value Developed technology $ 30,570 $ (10,556 ) $ 20,014 Trade names and trademarks 2,000 (592 ) 1,408 Independent sales agency network 4,500 (3,767 ) 733 Non-compete 260 (101 ) 159 Total $ 37,330 $ (15,016 ) $ 22,314 Identifiable intangible assets consisted of the following as of December 31, 2018: Original Accumulated Net Book Cost Amortization Value Developed technology $ 29,820 $ (8,454 ) $ 21,366 Trade names and trademarks 2,000 (413 ) 1,587 Independent sales agency network 4,500 (1,569 ) 2,931 Non-compete 260 (53 ) 207 Total $ 36,580 $ (10,489 ) $ 26,091

Accrued Expenses (Tables)

Accrued Expenses (Tables)	9 Months Ended
	Sep. 30, 2019
Payables and Accruals [Abstract]
Schedule of Accounts Payable and Accrued Liabilities	Accrued expenses and other current liabilities consisted of the following: September 30, December 31, 2019 2018 Accrued personnel costs $ 15,100 $ 15,218 Other 5,506 5,170 $ 20,606 $ 20,388

Line of Credit and Notes Paya_2

Line of Credit and Notes Payable (Tables)	9 Months Ended
	Sep. 30, 2019
Line of Credit Facility [Abstract]
Schedule of line of credit facilities	Line of credit and notes payable consisted of the following: September 30, December 31, 2019 2018 Line of credit $ 33,484 $ 26,484 Term loan 50,000 — Less debt discount and debt issuance cost (401 ) — less current maturities — — Term loan, net of debt discount and debt issuance cost $ 49,599 $ — Notes payable — 15,885 Less debt discount and debt issuance cost — (762 ) less current maturities — (2,545 ) Notes payable, net of debt discount and debt issuance cost $ — $ 12,578
Schudle of future payments of term loan facility	Future payments of Term Loan Facility, as of September 30, 2019, are as follows for the calendar years ended December 31: 2019 $ — 2020 — 2021 13,888 2022 16,667 2023 16,667 2024 2,778 Total $ 50,000

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	9 Months Ended
	Sep. 30, 2019
Equity [Abstract]
Schedule Of Common Stock Shares Reserved For Future Issuance [Table Text Block]	At September 30, 2019 and December 31, 2018, the Company has reserved the following shares of Class A common stock for future issuance: September 30, December 31, 2019 2018 Shares reserved for issuance for outstanding options 6,588,000 6,590,195 Shares reserved for issuance for future option grant 9,008,996 9,108,996 Shares reserved for issuance under the warrants — 17,732,700 Total shares of authorized common stock reserved for future issuance 15,596,996 33,431,891

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2019
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Schedule of Fair Value of Stock Options Granted to Employees and Directors	The assumptions that the Company used to determine the grant-date fair value of stock options granted during these periods were as follows, presented on a weighted-average basis: September 30, September 30, Risk-free interest rate 2.24 % 2.74 % Expected term (in years) 6.50 5.82 Expected volatility 42.7 % 42.9 % Expected dividend yield 0.0 % 0.0 % Exercise price $ 7.08 $ 5.40 Underlying stock price $ 7.08 $ 5.40
Summary of Stock Option Activity	The following table summarizes the Company’s stock option activity since December 31, 2018 (in thousands, except share and per share amounts): Number of Weighted Weighted Aggregate Outstanding as of December 31, 2018 7,266,185 $ 1.92 5.89 $ 33,909 Granted 100,000 7.08 Canceled / forfeited (11,150 ) 2.87 Exercised (91,045 ) 1.77 382 Outstanding as of September 30, 2019 7,263,990 1.99 5.31 33,359 Options exercisable as of September 30, 2019 5,736,926 1.59 4.69 28,546 Options vested or expected to vest as of September 30, 2019 7,025,841 $ 1.91 5.20 $ 32,797

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	9 Months Ended
	Sep. 30, 2019
Earnings Per Share [Abstract]
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	The Company excluded the following potential shares of Class A common stock, presented based on amounts outstanding at each period end, from the computation of diluted net loss per share attributable to the common stockholders of Organogenesis Holdings Inc. for the periods indicated because including them would have had an anti-dilutive effect: Nine Months Ended September 30, 2019 2018 Options to purchase common stock 7,263,990 7,178,774 Redeemable common stock — 728,548 Warrants to purchase common stock — 1,561,485 7,263,990 9,468,807

Commitments and Contingencies (

Commitments and Contingencies (Tables)	9 Months Ended
	Sep. 30, 2019
Commitments and Contingencies Disclosure [Abstract]
Future Lease Payments	2019 (remaining three months) $ 1,180 2020 4,721 2021 4,721 2022 4,945 2023 — Thereafter 9,692 25,259 Less amount representing interest (7,494 ) Present value of minimum lease payments 17,765 Less current maturities (2,872 ) Long-term portion $ 14,893
Schedule Of Operating Leased Assets	2019 (remaining three months) $ 1,218 2020 5,714 2021 5,053 2022 2,558 2023 1,180 Thereafter 8,123 $ 23,846

Nature of the Business and Ba_2

Nature of the Business and Basis of Presentation - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Organization and Financing
Working capital	$ 24,100		$ 24,100
Cash	22,974		22,974		$ 21,291
Accumulated deficit	(166,609)		(166,609)		$ (130,240)
Net loss	$ (10,741)	$ (13,078)	(36,056)	$ (55,576)
Cash used in operation			(27,127)	$ (43,230)
Accounting Standards Update 2013-07 [Member]
Organization and Financing
Net loss			36,100
Cash used in operation			$ 27,100

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Schedule of Revenue by Product Category (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Total net revenue	$ 64,265	$ 50,769	$ 186,336	$ 129,850
Advanced Wound Care
Total net revenue	54,310	43,597	157,365	109,711
Surgical & Sports Medicine
Total net revenue	$ 9,955	$ 7,172	$ 28,971	$ 20,139

Significant Accounting Policies

Significant Accounting Policies - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Significant Accounting Policies [Line Items]
Revenue	$ 64,265	$ 50,769	$ 186,336	$ 129,850
GPO Fees	$ 880	$ 581	$ 1,991	$ 1,304
Sales Revenue
Significant Accounting Policies [Line Items]
Concentration Risk, Percentage	1.00%	1.00%	1.00%	1.00%
PuraPly
Significant Accounting Policies [Line Items]
Revenue	$ 31,755	$ 17,872	$ 86,893	$ 41,261

Fair Value Measurement of Finan

Fair Value Measurement of Financial Instruments - Financial Assets And Liabilities Measured At Fair Value (Detail) - Fair Value, Measurements, Recurring $ in Thousands	Dec. 31, 2018USD ($)
Liabilities:
Redeemable common stock liability	$ 6,762
Redeemable common stock liability
Liabilities:
Redeemable common stock liability	6,762
Fair Value, Inputs, Level 3
Liabilities:
Redeemable common stock liability	6,762
Fair Value, Inputs, Level 3 | Redeemable common stock liability
Liabilities:
Redeemable common stock liability	$ 6,762

Fair Value of Financial Asset_3

Fair Value of Financial Assets and Liabilities - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	Mar. 24, 2017	Mar. 24, 2019	Sep. 30, 2019	Dec. 31, 2018
Company issued acquisition of shares		728,548
Treasury stock			728,548
NuTech Medical
Temporary Equity, Redemption Price Per Share		$ 9.28
Common Class A
Redeemable common stock, Carrying amount				$ 6,762
Common Class A | NuTech Medical
Company issued acquisition of shares	728,548
Business Acquisition, Share Price	$ 8.69

Accounts receivable, net (Detai

Accounts receivable, net (Detail) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Receivables [Abstract]
Accounts receivable	$ 37,318	$ 37,497
Less — allowance for sales returns and doubtful accounts	(2,935)	(3,420)
Accounts receivable	$ 34,383	$ 34,077

Accounts receivable, net - Sale

Accounts receivable, net - Sales Returns and Doubtful Accounts (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Balance	$ 3,021	$ 2,853	$ 3,420	$ 3,225
Additions (reductions)	(56)	289	(29)	(18)
Write-offs	(30)	(51)	(456)	(116)
Balance	$ 2,935	$ 3,091	$ 2,935	$ 3,091

Inventories (Detail)

Inventories (Detail) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Raw materials	$ 7,430	$ 4,711
Work in process	1,355	1,759
Finished goods	11,399	6,851
Inventory	$ 20,184	$ 13,321

Inventories - Additional Inform

Inventories - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Inventory Reserve And Obsolence Charged To Cost Of Goods Sold	$ 286	$ 370	$ 809	$ 2,068
Reserve for excess and obsolete inventory	$ 1,262		$ 1,262		$ 1,206

Property and Equipment, Net (De

Property and Equipment, Net (Detail) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Property, Plant and Equipment, Gross	$ 81,130	$ 79,097
Accumulated depreciation and amortization	(64,977)	(62,435)
Property, Plant and Equipment, Net	44,254	39,623
Leasehold improvements
Property, Plant and Equipment, Gross	35,092	34,345
Furniture, computers and equipment
Property, Plant and Equipment, Gross	46,038	44,752
Construction in progress
Property, Plant and Equipment, Net	$ 28,101	$ 22,961

Property and Equipment, Net - A

Property and Equipment, Net - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Depreciation expense	$ 792	$ 861	$ 2,553	$ 2,608
Leasehold improvements
Capital leases recorded within leasehold improvements	21,689		21,689		$ 21,689
Capital leases recorded	$ 13,477		$ 13,477		$ 12,579

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Identifiable intangible assets (Detail) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Original Cost	$ 37,330	$ 36,580
Accumulated Amortization	(15,016)	(10,489)
Net Book Value	22,314	26,091
Developed technology
Original Cost	30,570	29,820
Accumulated Amortization	(10,556)	(8,454)
Net Book Value	20,014	21,366
Trade names and trademarks
Original Cost	2,000	2,000
Accumulated Amortization	(592)	(413)
Net Book Value	1,408	1,587
Independent sales agency network
Original Cost	4,500	4,500
Accumulated Amortization	(3,767)	(1,569)
Net Book Value	733	2,931
Non-compete agreements
Original Cost	260	260
Accumulated Amortization	(101)	(53)
Net Book Value	$ 159	$ 207

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	1 Months Ended	3 Months Ended		9 Months Ended
	Apr. 30, 2019	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Goodwill		$ 25,539		$ 25,539		$ 25,539
Amortization of Intangible Assets		$ 1,529	$ 918	4,526	$ 2,752
Intangible asset purchase, cash paid				250
Intangible asset purchase, remaining payables				500
Developed Technology Rights [Member]
Intangible asset purchase, value	$ 750
Intangible asset purchase, cash paid	$ 250
Intangible asset purchase, remaining payables				$ 500

Accrued Expenses and Other Curr

Accrued Expenses and Other Current Liabilities (Detail) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Payables and Accruals [Abstract]
Accrued personnel costs	$ 15,100	$ 15,218
Other	5,506	5,170
Total Accrued Expenses and Other Current Liabilities	$ 20,606	$ 20,388

Line of Credit and Notes Paya_3

Line of Credit and Notes Payable (Detail) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Line of credit		$ 26,484
Term loan	$ 50,000
Notes payable		15,885
Less debt discount and debt issuance cost		(762)
less current maturities		(2,545)
Notes payable, net of debt discount and debt issuance cost		$ 12,578
New Credit Facility [Member]
Line of credit	33,484
Term loan	50,000
Term loan, net of debt discount and debt issuance cost	49,599
Less debt discount and debt issuance cost	$ (401)

Line of Credit and Notes Paya_4

Line of Credit and Notes Payable - Future payments of term loan (Detail) $ in Thousands	Sep. 30, 2019USD ($)
2019	$ 0
2020	0
2021	13,888
2022	16,667
2023	16,667
2024	2,778
Total	$ 50,000

Line of Credit and Notes Paya_5

Line of Credit and Notes Payable - Additional Information (Detail) - USD ($) $ in Thousands	Mar. 14, 2019	Dec. 31, 2019	Apr. 30, 2018	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Apr. 28, 2018	May 01, 2017	Mar. 21, 2017
Letter of credit sub facility													$ 26,484
Revenues				$ 64,265			$ 50,769	$ 186,336	$ 129,850
Loss on the extinguishment of loan								(1,862)
ML Agreement
Loss on the extinguishment of loan						$ 1,862
Credit Agreement
Letter of credit sub facility	$ 26,541
Future revolving borrowings													$ 3,516
Additional fund			$ 5,000
Aggregate amounts of term loan			35,000
New Credit Agreement
Term Loan Facility, financial covenants	Borrower's achievement of trailing twelve month Consolidated Revenue of not less than $221,250 and a trailing three month Adjusted EBITDA (as defined in the New Credit Agreement) loss not in excess of $5,000;												maintain Minimum Liquidity (as defined in the New Credit Agreement) equal to the greater of (i) 6 months Monthly Burn (as defined in the New Credit Agreement) and (ii) $10,000.
Aggregate amounts of term loan						100,000						$ 100,000
Proceeds from Issuance of Debt								50,000
Debt Instrument, Basis Spread on Variable Rate				3.75%
Debt Instrument, Description of Variable Rate Basis	interest rate equal to 3.75% above the Wall Street Journal Prime Rate
Additional payment in aggregate of the principal amount percentage	6.25%
Advance outstanding amount revolving facility	25.00%
Unused Line Fee	0.25%
EBITDA income (loss)					$ 5,000
New Credit Agreement | Repaid Before One year
Termination fee percentage	4.00%
Prepayment premium percentage	3.00%
New Credit Agreement | Repaid After One year Before Two Years
Termination fee percentage	3.00%
Prepayment premium percentage	2.00%
New Credit Agreement | Repaid After Two year Before Three Years [Member]
Termination fee percentage	2.00%
Prepayment premium percentage	1.00%
New Credit Agreement | Repaid After Three Years [Member]
Termination fee amount	$ 0
Prepayment premium percentage	0.00%
New Credit Agreement | Tranche One [Member]
Aggregate principal amount	$ 40,000
New Credit Agreement | Tranche Two [Member]
Aggregate principal amount				$ 10,000				10,000		$ 10,000
Expiration Date	Sep. 30, 2019
New Credit Agreement | Tranche Three [Member]
Aggregate principal amount				10,000				10,000		10,000
Expiration Date	Mar. 31, 2020
New Credit Agreement | Minimum Trailing Twelve Month Achievement [Member]
Revenues		$ 231,500		221,250						221,250	$ 213,500	200,000
Eastward fund LLC
Letter of credit sub facility														$ 16,000
Aggregate amounts of term loan														$ 20,000
Percentage of final payment fee															6.50%
Eastward fund LLC | Repaid Before Two Years
Prepayment fees															3.00%
Eastward fund LLC | Repaid After Two Years
Prepayment fees															2.00%
Term Loan | Credit Agreement
Aggregate amounts of term loan			$ 5,000
Term Loan | New Credit Agreement
Debt Issuance Costs, Net				554				554		554
Term Loan | New Credit Agreement | Tranche Three [Member]
Debt Issuance Costs, Net						92						92
Term Loan | New Credit Agreement | Tranche One and Tranche Two
Debt Issuance Costs, Net				462				462		462
Revolving Credit Facility | Credit Agreement
Letter of credit sub facility																$ 30,000
Aggregate under revolving credit facility													$ 26,484
Aggregate amounts of term loan																$ 30,000
Revolving Credit Facility | New Credit Agreement
Letter of credit sub facility				33,484		$ 40,000		33,484		33,484		$ 40,000
Future revolving borrowings				$ 6,516				$ 6,516		$ 6,516
Debt Issuance Costs, Net							$ 370		$ 370

Stockholders' Equity (Detail)

Stockholders' Equity (Detail) - shares	Sep. 30, 2019	Dec. 31, 2018
Equity [Abstract]
Shares reserved for issuance for outstanding options	6,588,000	6,590,195
Shares reserved for issuance for future option grant	9,008,996	9,108,996
Shares reserved for issuance under the warrants	0	17,732,700
Common Stock, Capital Shares Reserved for Future Issuance	15,596,996	33,431,891

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	Jul. 22, 2019	Mar. 24, 2019	Sep. 30, 2019	Sep. 30, 2019	Aug. 19, 2019	Aug. 16, 2019	Aug. 13, 2019	Jul. 12, 2019	Dec. 31, 2018
Common stock, shares authorized			400,000,000	400,000,000					400,000,000
Common stock, par value			$ 0.0001	$ 0.0001					$ 0.0001
Company issued acquisition of shares		728,548
Common Stock, Shares, Issued			95,470,290	95,470,290					91,261,413
Class of Warrant or Right, Outstanding			0	0
Common stock issuable upon warrant exercise			0	0					17,732,700
Non-cash deemed dividend to warrant holders			$ (645)	$ 645
Pipe warrants [Member]
Class of Warrant or Right, Outstanding								4,100,000
Warrant Exchange agreement [Member]
Class of Warrant or Right, Outstanding	30,900,000
Number of warrants exchanged for share issue	29,950,150
Massachusetts Capital Resource Company Life Insurance Community Investment Initiative LLC [Member]
Common stock issuable upon warrant exercise							19,426
Common Class A
Common Stock, Shares, Issued			95,470,290	95,470,290
Percentage of common stock outstanding as a result of warrant conversion			3.00%	3.00%
Common Class A | Pipe warrants [Member]
Common stock issuable upon warrant exercise								389,501
Common Class A | Warrant Exchange agreement [Member]
Number Of Securities Called By Each Warrant	0.095
Common stock issuable upon warrant exercise						2,845,280
Common Class A | Warrant Exchange Amendment Agreement [Member]
Number Of Securities Called By Each Warrant					0.0855
Common stock issuable upon warrant exercise					80,451
Common Class A | Warrant Exchange Agreement Total
Common stock issuable upon warrant exercise			3,334,658	3,334,658
Common Class A | Massachusetts Capital Resource Company Life Insurance Community Investment Initiative LLC [Member]
Excecise price of warrants per unit							$ 3.95
Common stock issuable upon warrant exercise							182,700

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Common stock options outstanding	7,263,990		7,263,990		7,266,185
Share-based compensation expense	$ 242	$ 252	$ 700	$ 820
Weighted average grant-date fair value			$ 3.24	$ 2.39
Fair value of option vested			$ 538	$ 503
Unrecognized stock compensation expense	1,444		$ 1,444
Share-based compensation expected to be recognized over a weighted-average period			2 years 7 months 2 days
Exercise of stock options			91,045
Option Loans
Related Parties Notes Receivable	$ 635		$ 635
Number of shares issued as collateral for the option loans	675,990		675,990
2003 and 2018 Stock Incentive Plan
Stock option expiration period			10 years
Common Class A | Executive Officer
Exercise of stock options					7,176,715
Common Class A | 2018 Stock Incentive Plan
Common stock options authorized	9,198,996		9,198,996
Common stock options outstanding	190,000		190,000

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Fair Value of Stock Options Granted to Employees and Directors (Detail) - $ / shares	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Risk-free interest rate	2.24%	2.74%
Expected term (in years)	6 years 6 months	5 years 9 months 25 days
Expected volatility	42.70%	42.90%
Expected dividend yield	0.00%	0.00%
Exercise price	$ 7.08	$ 5.40
Underlying stock price	$ 7.08	$ 5.40

Stock-Based Compensation -Paren

Stock-Based Compensation -Parenthetical (Detail) - shares	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
options granted	100,000	78,111

Stock-Based Compensation - Summ

Stock-Based Compensation - Summary of Stock Option Activity (Detail) - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended		12 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Number of Shares Outstanding	7,266,185
Number of Shares Granted	100,000	78,111
Number of Shares Canceled / forfeited	(11,150)
Number of Shares Exercised	(91,045)
Number of Shares Outstanding	7,263,990		7,266,185
Number of Shares Options Exercisable	5,736,926
Number of Shares Options vested or expected to vest	7,025,841
Weighted Average Exercise Price Outstanding	$ 1.92
Weighted Average Exercise Price Granted	7.08
Weighted Average Exercise Price Cancelled / forfeited	2.87
Weighted Average Exercise Price Exercised	1.77
Weighted Average Exercise Price Outstanding	1.99		$ 1.92
Weighted Average Exercise Price Options Exercisable	1.59
Weighted Average Exercise Price Options Vested or Expected to Vest	$ 1.91
Weighted Average Remaining Contractual Term (in years) Outstanding	5 years 3 months 21 days		5 years 10 months 20 days
Weighted Average Remaining Contractual Term (in years) Options Exercisable	4 years 8 months 8 days
Weighted Average Remaining Contractual Term (in years) Options Vested or Expected to Vest	5 years 2 months 12 days
Aggregate Intrinsic Value Outstanding	$ 33,359		$ 33,909
Aggregate Intrinsic Value Options Exercised	382
Aggregate Intrinsic Value Options Exercisable	28,546
Aggregate Intrinsic Value Options Vested or Expected to Vest	$ 32,797

Net Loss Per Share - Schedule o

Net Loss Per Share - Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share (Detail) - shares	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	7,263,990	9,468,807
Employee Stock Option
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	7,263,990	7,178,774
Redeemable Common Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	0	728,548
Warrant
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	0	1,561,485

Commitments and Contingencies_2

Commitments and Contingencies (Schedule of leases payments) (Detail) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
2019	$ 1,180
2020	4,721
2021	4,721
2022	4,945
2023	0
Thereafter	9,692
Total	25,259
Less amount representing interest	(7,494)
Present value of minimum lease payments	17,765
Less current maturities	(2,872)	$ (2,236)
Long-term portion	$ 14,893	$ 15,418

Commitments and Contingencies_3

Commitments and Contingencies (Schedule Of Operating Leased Assets) (Detail) $ in Thousands	Sep. 30, 2019USD ($)
2019 (remaining three months)	$ 1,218
2020	5,714
2021	5,053
2022	2,558
2023	1,180
Thereafter	8,123
Total	$ 23,846

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) ft² in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019USD ($)ft²	Sep. 30, 2018USD ($)	Sep. 30, 2019USD ($)ft²	Sep. 30, 2018USD ($)	Jan. 31, 2019USD ($)	Dec. 31, 2018USD ($)
Accrued Legal Expenses	$ 542		$ 542			$ 1,000
Capital lease rental arrears	6,042		6,042			5,265
Operating Lease, Expense	1,766	$ 1,218	4,993	$ 3,630
Business Combination Contingent Consideration Liability Accrued Interest	$ 842		$ 842
Land Subject to Ground Leases | ft²	43,850		43,850
Annual lease payments during the first year	$ 1,052		$ 1,052
Annual lease payments ten year lease term	44		44
Annual lease payments five year lease term	33		33
Security Deposit	526		526
Increase (Decrease) in Security Deposits			263
Accrued Interest	478		478
Principal and Interest
Capital lease rental arrears	10,336		10,336			10,293
Selling, General and Administrative Expenses
Royalty Expense	991	$ 506	2,695	$ 1,207
CAM Portion of Accrued Rent
Capital lease rental arrears	644		644			854
Accounts Payable and Accrued Liabilities
Accrued Royalties	$ 1,187		$ 1,187
Dan Road Associates
Capital Lease Obligations					$ 4,308
Capital Leases Aggregate Annual Lease Payments Rent Percentage	10.00%		10.00%
Dan Road Associates | Interest
Capital lease rental arrears	$ 3,650		$ 3,650			$ 4,174
NuTech Medical
Deferred Acquisition Cost Paid			2,500
The amount, if any, of the remaining $5,000 of deferred acquisition consideration plus accrued interest owed to the sellers of NuTech Medical is currently in dispute.	5,000		5,000
Business Combination Deferred Consideration	$ 7,500		$ 7,500

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Detail) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Dec. 31, 2018
Net principal and interest receivable	$ 536	$ 477
NuTech Medical
Under the lease, the Company is required to make monthly rent payments of approximately	21
Option Loans
Related Parties Notes Receivable	635
Liquidity Loan to Two Former Employee
Note Receivable	$ 2,350	$ 2,350
Class A
Stock Held By Employee	675,990	675,990
Maximum | Liquidity Loan and Option Loans
Interest Rate	3.86%
Minimum | Liquidity Loan and Option Loans
Interest Rate	2.30%